EXHIBIT_D_Price_Schedule__Final_30Aug.xlsx

XLSX spreadsheet 130 KB Posted

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Office of Wildland Fire Medical Qualification IDIQ
Solicitation number
140D0424R0071
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This document is a price schedule for an IDIQ contract opportunity for Office of Wildland Fire Medical Qualification Determination Services, Solicitation Number 140D0424R0071. The price schedule includes line items for various medical services such as exams, vaccinations, laboratory tests, and medical consultations, as well as fixed pricing for personnel, travel, and other event-related costs. The contract term is 5 years, from FY25 to FY29, with estimated quantities provided for each service. Pricing is presented on a per-unit basis, with totals calculated for each year. The document also includes a separate tab for mobile medical event pricing, covering personnel, lab analysis, testing, shipping, supplies, and travel. This pricing information will be negotiated and awarded as firm-fixed-price line items based on the established schedule and the specific needs of each event.

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FY25-29

140D0424R0071 - EXHIBIT D PRICE SCHEDULEYEAR 1YEAR 2YEAR 3YEAR 4YEAR 5
Service TitleEst. Qty.UnitUnit PriceSUBTOTALEst. Qty.UnitUnit PriceSUBTOTALEst. Qty.UnitUnit PriceSUBTOTALEst. Qty.UnitUnit PriceSUBTOTALEst. Qty.UnitUnit PriceSUBTOTAL
Phase-In1EA$0N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
Basic Exam250EA$0250EA$0250EA$0250EA$0250EA$0
Comprehensive Exam3400EA$03400EA$03400EA$03400EA$03400EA$0
Periodic Exam1800EA$01800EA$01800EA$01800EA$01800EA$0
Tetanus Vaccine - Td or Tdap1800EA$01800EA$01800EA$01800EA$01800EA$0
Tuberculosis Skin Test (PPD)520EA$0520EA$0520EA$0520EA$0520EA$0
Missed Appointment545EA$0545EA$0545EA$0545EA$0545EA$0
Medical Review/ Qualification Determination5500EA$05500EA$05500EA$05500EA$05500EA$0
Medical Review/ Qualification Determination - NPS LE, 90 Days650EA$0650EA$0650EA$0650EA$0650EA$0
Hyperbaric Physician Qualification Determination10EA$010EA$010EA$010EA$010EA$0
Diver Qualification Determination90EA$090EA$090EA$090EA$090EA$0
Limited Medical Review / Qualification Determination1000EA$01000EA$01000EA$01000EA$01000EA$0
Self-Certification / Pre-Fitness Medical Review1500EA$01500EA$01500EA$01500EA$01500EA$0
RMO Field Orientation - Daily Rate, Includes Travel60EA$036EA$036EA$036EA$036EA$0
Medical Consultation500HR$0500HR$0500HR$0500HR$0500HR$0
Audiogram26EA$026EA$026EA$026EA$026EA$0
OSHA Respiratory Questionnaire100EA$0100EA$0100EA$0100EA$0100EA$0
Laboratory Urinalysis1000EA$01000EA$01000EA$01000EA$01000EA$0
Chest X-Ray (PA View)800EA$0800EA$0800EA$0800EA$0800EA$0
Lead, industrial whole blood and ZPP - In Conjunction With Periodic Exam250EA$0250EA$0250EA$0250EA$0250EA$0
Lead, industrial whole blood and ZPP - Without Exam550EA$0550EA$0550EA$0550EA$0550EA$0
Lead, industrial whole blood, ZPP and audiogram - Without Exam250EA$0250EA$0250EA$0250EA$0250EA$0
Cholinesterase Baseline800EA$0800EA$0800EA$0800EA$0800EA$0
EKG500EA$0500EA$0500EA$0500EA$0500EA$0
Fitness for Duty - Adult Specialty Medicine50EA$050EA$050EA$050EA$050EA$0
Fitness for Duty - Mental Health Specialist50EA$050EA$050EA$050EA$050EA$0
Fitness for Duty - Vision/Hearing Specialist50EA$050EA$050EA$050EA$050EA$0
Mobile Medical Events - See Separate Tab
Grand Total - Annual$0$0$0$0$0

Contract No. 140L0620D0002 ATTACHMENT B &A

&G CONTROLLED//SSEL/PROPRIETARY//DISSEM-FED ONLY Page 1 of 2

Mobile Event Price Schedule

EXHIBIT D PRICE SCHEDULE
YEAR 01YEAR 02YEAR 03YEAR 04YEAR 05
PERSONNEL*UnitQTYRateAmountUnitQTYRateAmountUnitQTYRateAmountUnitQTYRateAmountUnitQTYRateAmount
Program ManagerHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
Event/Logistics CoordinatorHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
On-site LeadHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
PA/NPHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
RNHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
Medical InterpreterHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0
Medical TechHour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0Hour1$ - 0$ - 0
11111
PER EXAM/EVENT ITEMS***11111
Lab AnalysisExam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0
TB TestingExam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0
TetanusExam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0Exam1$ - 0
Shipping of On-site Materials++Event1$ - 0Event1$ - 0$ - 0Event1$ - 0$ - 0Event1$ - 0$ - 0Event1$ - 0
Supplies++Event1$ - 0Event1$ - 0$ - 0Event1$ - 0$ - 0Event1$ - 0$ - 0Event1$ - 0
11111
TRAVEL**

tc={D3D45690-303A-4359-A51D-59E3BF144DB2}: [Threaded comment]

Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924

Comment:

Possibly delete the line items here since these will be negotiated at TO level.11111
Flight / BaggageEach1$ - 0Each1$ - 0Each1$ - 0Each1$ - 0Each1$ - 0
Per DiemDay1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0
LodgingDay1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0
Vehicle Rental(s)Day1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0Day1$ - 0
MileageMile1$ - 0Mile1$ - 0Mile1$ - 0Mile1$ - 0Mile1$ - 0
Tolls / Fuel / ParkingEvent1$ - 0Event1$ - 0Event1$ - 0Event1$ - 0Event1$ - 0
*Personnel will be negotiated and awarded as a firm fixed price line item based upon rates established in price schedule and reasonable staffing to meet event needs.
**Travel - will be negotiated and awarded as a firm fixed price line item based upon available commercial pricing and federal per diem rates.
++Supplies and shipping of materials will be negotiated and awarded as a firm fixed price line item. Quotes will be provided based upon location, quantities, and scheduling needs for each event.
***Per exam and event items will be invoiced as incurred at fixed price established in the price schedule.

Contract No. 140L0620D0002 ATTACHMENT B &A

&G CONTROLLED//SSEL/PROPRIETARY//DISSEM-FED ONLY Page 2 of 2 image1.png

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