Atch_1 _Pricing_Schedule__26_May_15.doc

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Occupational Health Care (OHC) and Consultation Service of Local National Civilians
Solicitation number
FA5613-15-R-0007
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Attachment 1, Pricing Schedule

FA5613-15-R-0007

Added Schedule Items:

CONTRACT ADMINISTRATION

(1)

ORDERING

(i) Task Orders (TOs)/Blanket Delivery Orders (BDOs) will be issued by a warranted contracting officer located at:

700th Contracting Squadron

Kapaun Air Station, GEB # 2767

67661 Kaiserslautern

52nd Contracting Squadron

U.S. Einkaufbuero

GEB # 128, Arnold Blvd

54529 Flugplatz Spangdahlem

(ii) TOs/BDOs will be issued on Standard Form 1449, Order for Commercial Items in accordance with the terms and conditions of the contract.

(iii) The Government may (1) elect to issue a TO for a single occupational health care/consultation service or multiple occupational health care/consultation services, or (2) issue a BDO under which authorized personnel will place calls for occupational health care and consultation services. Each TO/BDO will include the firm fixed unit prices set forth in this contract. The TO will include a firm fixed total price, while the final price of a BDO will be dependent on the calls placed by authorized personnel and shall not exceed the price of the BDO, unless adjusted by the Contracting Officer. 700 CONS and 52 CONS shall authorize Government personnel to place calls against the BDOs. The individual(s) authorized to place calls will be identified in the BDO or by separate letter. All BDOs shall contain the following information in addition to the items specified in FAR 16.505(a)(7):

· Individual(s) authorized to place calls;

· Call numbers for each location;

· Name and address of contractor;

· Monthly reporting requirements;

· Individuals responsible for inspection & acceptance

Base Period 01 Oct 2015 – 30 Sep 2016, CLINs 0001 through 0034

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
311
Each
EUR____________
EUR________________

Medical Examinations FFP (Firm Fixed Price)

With diagnosis by physician (i.e. hearing, screening test per ArbSchVV) in accordance with (IAW) the attached Performance Work Statement (PWS).

Period of Performance from 01 October 2015 through 30 September 2016.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
296
Each
EUR____________
EUR________________

Occupational Health Total Examination

Per ArbSchVV to include: health history, physical, clinical examination, vision test, hearing test, pulmonary function test, EKG test, small laboratory, blood count, urinanalysis, Gamma GT and GPT, documentation, diagnosis, and reporting IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
182
Each
EUR____________
EUR________________

Occupational Health Total Examination

With medical-technical and toxicological-analytical parameters not covered under CLIN 0002 (i.e. lead, benzene, toluene) as well as x-ray examination and/or exercise EKG (Ergometry) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Hepatitis A Immunization Initial/Booster

(One single shot as initial or booster to include vaccine, consultation and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
12
Each
EUR____________
EUR________________

Hepatitis A Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Hepatitis B Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Hepatitis B Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
130
Each
EUR____________
EUR________________

Hepatitis AB Immunization Initial/Boost

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
160
Each
EUR____________
EUR________________

Hepatitis AB Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Varicella Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Varicella Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization

(combination vaccine) (one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization Boost

(combination vaccine) (one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Tetanus Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
18
Each
EUR____________
EUR________________

Tetanus/Diphteria (Td) Immunization

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

FSME Immunization Initial/Booster

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Rabies Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Rabies Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Pertussius Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
120
Each
EUR____________
EUR________________

Titer determination

Prior or following an immunization. CLIN will be used per test indicating which parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
52
Each
EUR____________
EUR________________

Consultation, Blood Taking, & Doc.

IAW the attached PWS

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
195
Each
EUR____________
EUR________________

Work site inspections, briefing, safety

Activities related to work area (i.e. work site inspections, briefing, and safety meetings) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
31
Each
EUR____________
EUR________________

Diagnosis/Examination of reports

On problematic cases by qualified doctor. (Begutachtung in Std) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Medical referral to specialist

To complete more extensive testing and evaluation that may not be available from the contractor (i.e. audiologist, optometrist, etc.). The price shall include the special test and/or needed examination IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 0001 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 0002 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 0003 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
20
Each
EUR____________
EUR________________

Analysis of biological material

(blood or urine) from employees for presence of hazardous substances. These tests will be ordered for employees referred under CLIN 0003 (e.g. Heavy Metal or Benzene series), only if indicated. CLIN will be used per test indicating parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
14
Each
EUR____________
EUR________________

X-ray, set of two pictures

One PA (chest straight ahead) and one left lateral (left side facing screen). This examination will be necessary for those employees who were referred to under CLIN 0003 (Heavy Metal testing), and only if clinically indicated. The appointments will be scheduled IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Tuberculin Test

This test is administered to rule out an explosure to tuberculosis. The exam is included in the unit price IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Color Vision Examination

IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
30
Each
EUR____________
EUR________________

Truck Driver Examination

For Class C License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
13
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, perimetrical testing, and a psychological reaction test IAW the attached PWS.

Total for Base Period, CLINs 0001 through 0034:

ESTIMATED EUR______________

1st Option Period 01 Oct 2016 – 30 Sep 2017, CLINs 1001 through 1034

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
311
Each
EUR____________
EUR________________

Medical Examinations

With diagnosis by physician (i.e. hearing, screening test per ArbSchVV) IAW the attached PWS.

Period of Performance from 01 October 2016 through 30 September 2017.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
296
Each
EUR____________
EUR________________

Occupational Health Total Examination

Per ArbSchVV to include: health history, physical, clinical examination, vision test, hearing test, pulmonary function test, EKG test, small laboratory, blood count, urinanalysis, Gamma GT and GPT, documentation, diagnosis, and reporting IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
182
Each
EUR____________
EUR________________

Occupational Health Total Examination

With medical-technical and toxicological-analytical parameters not covered under CLIN 0002 (i.e. lead, benzene, toluene) as well as x-ray examination and/or exercise EKG (Ergometry) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Hepatitis A Immunization Initial/Booster

(One single shot as initial or booster to include vaccine, consultation and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
12
Each
EUR____________
EUR________________

Hepatitis A Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Hepatitis B Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Hepatitis B Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
130
Each
EUR____________
EUR________________

Hepatitis AB Immunization Initial/Boost

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
160
Each
EUR____________
EUR________________

Hepatitis AB Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Varicella Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Varicella Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization

(combination vaccine) (one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization Boost

(combination vaccine) (one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Tetanus Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
18
Each
EUR____________
EUR________________

Tetanus/Diphteria (Td) Immunization

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

FSME Immunization Initial/Booster

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Rabies Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Rabies Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Pertussius Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
120
Each
EUR____________
EUR________________

Titer determination

Prior or following an immunization. CLIN will be used per test indicating which parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
52
Each
EUR____________
EUR________________

Consultation, Blood Taking, & Doc.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
195
Each
EUR____________
EUR________________

Work site inspections, briefing, safety

Activities related to work area (i.e. work site inspections, briefing, and safety meetings) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
31
Each
EUR____________
EUR________________

Diagnosis/Examination of reports

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Medical referral to specialist

To complete more extensive testing and evaluation that may not be available from the contractor (i.e. audiologist, optometrist, etc.) The price shall include the special test and/or needed examination IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 1001 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 1002 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 1003 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
20
Each
EUR____________
EUR________________

Analysis of biological material

(blood or urine) from employees for presence of hazardous substances. These tests will be ordered for employees referred under CLIN 1003 (e.g. Heavy Metal or Benzene series), only if indicated. CLIN will be used per test indicating parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
14
Each
EUR____________
EUR________________

X-ray, set of two pictures

One PA (chest straight ahead) and one left lateral (left side facing screen). This examination will be necessary for those employees who were referred to under CLIN 0003 (Heavy Metal testing), and only if clinically indicated. The appointments will be scheduled IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Tuberculin Test

This test is administered to rule out an explosure to tuberculosis. The exam is included in the unit price IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Color Vision Examination

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
30
Each
EUR____________
EUR________________

Truck Driver Examination

For Class C License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
13
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, perimetrical testing, and a psychological reaction test IAW the attached PWS.

Total for 1st Option Period, CLINs 1001 through 1034:

EUR_________________

2nd Option Period 01 Oct 2017 – 30 Sep 2018, CLINs 2001 through 2034

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
311
Each
EUR____________
EUR________________

Medical Examinations

Period of Performance from 01 October 2017 through 30 September 2018.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
296
Each
EUR____________
EUR________________

Occupational Health Total Examination

Per ArbSchVV to include: health history, physical, clinical examination, vision test, hearing test, pulmonary function test, EKG test, small laboratory, blood count, urinanalysis, Gamma GT and GPT, documentation, diagnosis, and reporting IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
182
Each
EUR____________
EUR________________

Occupational Health Total Examination

With medical-technical and toxicological-analytical parameters not covered under CLIN 0002 (i.e. lead, benzene, toluene) as well as x-ray examination and/or exercise EKG (Ergometry) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Hepatitis A Immunization Initial/Booster

(One single shot as initial or booster to include vaccine, consultation and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
12
Each
EUR____________
EUR________________

Hepatitis A Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Hepatitis B Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Hepatitis B Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
130
Each
EUR____________
EUR________________

Hepatitis AB Immunization Initial/Boost

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
160
Each
EUR____________
EUR________________

Hepatitis AB Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Varicella Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Varicella Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization

(combination vaccine) (one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization Boost

(combination vaccine) (one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Tetanus Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
18
Each
EUR____________
EUR________________

Tetanus/Diphteria (Td) Immunization

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

FSME Immunization Initial/Booster

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Rabies Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Rabies Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Pertussius Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
120
Each
EUR____________
EUR________________

Titer determination

Prior or following an immunization. CLIN will be used per test indicating which parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
52
Each
EUR____________
EUR________________

Consultation, Blood Taking, & Doc.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
195
Each
EUR____________
EUR________________

Work site inspections, briefing, safety

Activities related to work area (i.e. work site inspections, briefing, and safety meetings) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
31
Each
EUR____________
EUR________________

Diagnosis/Examination of reports

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Medical referral to specialist

To complete more extensive testing and evaluation that may not be available from the contractor (i.e. audiologist, optometrist, etc.) The price shall include the special test and/or needed examination IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 2001 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 2002 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 2003 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
20
Each
EUR____________
EUR________________

Analysis of biological material

(blood or urine) from employees for presence of hazardous substances. These tests will be ordered for employees referred under CLIN 2003 (e.g. Heavy Metal or Benzene series), only if indicated. CLIN will be used per test indicating parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
14
Each
EUR____________
EUR________________

X-ray, set of two pictures

One PA (chest straight ahead) and one left lateral (left side facing screen). This examination will be necessary for those employees who were referred to under CLIN 0003 (Heavy Metal testing), and only if clinically indicated. The appointments will be scheduled IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Tuberculin Test

This test is administered to rule out an explosure to tuberculosis. The exam is included in the unit price IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Color Vision Examination

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
30
Each
EUR____________
EUR________________

Truck Driver Examination

For Class C License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
13
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, perimetrical testing, and a psychological reaction test IAW the attached PWS.

Total for 2nd Option Period, CLINs 2001 through 2034:

3rd Option Period 01 Oct 2018 – 30 Sep 2019, CLINs 3001 through 3034

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
311
Each
EUR____________
EUR________________

Medical Examinations

Period of Performance from 01 October 2018 through 30 September 2019.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
296
Each
EUR____________
EUR________________

Occupational Health Total Examination

Per ArbSchVV to include: health history, physical, clinical examination, vision test, hearing test, pulmonary function test, EKG test, small laboratory, blood count, urinanalysis, Gamma GT and GPT, documentation, diagnosis, and reporting IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
182
Each
EUR____________
EUR________________

Occupational Health Total Examination

With medical-technical and toxicological-analytical parameters not covered under CLIN 0002 (i.e. lead, benzene, toluene) as well as x-ray examination and/or exercise EKG (Ergometry) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Hepatitis A Immunization Initial/Booster

(One single shot as initial or booster to include vaccine, consultation and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
12
Each
EUR____________
EUR________________

Hepatitis A Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Hepatitis B Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Hepatitis B Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
130
Each
EUR____________
EUR________________

Hepatitis AB Immunization Initial/Boost

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
160
Each
EUR____________
EUR________________

Hepatitis AB Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Varicella Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Varicella Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization

(combination vaccine) (one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization Boost

(combination vaccine) (one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Tetanus Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
18
Each
EUR____________
EUR________________

Tetanus/Diphteria (Td) Immunization

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

FSME Immunization Initial/Booster

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Rabies Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Rabies Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Pertussius Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
120
Each
EUR____________
EUR________________

Titer determination

Prior or following an immunization. CLIN will be used per test indicating which parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
52
Each
EUR____________
EUR________________

Consultation, Blood Taking, & Doc.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
195
Each
EUR____________
EUR________________

Work site inspections, briefing, safety

Activities related to work area (i.e. work site inspections, briefing, and safety meetings) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
31
Each
EUR____________
EUR________________

Diagnosis/Examination of reports

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Medical referral to specialist

To complete more extensive testing and evaluation that may not be available from the contractor (i.e. audiologist, optometrist, etc.) The price shall include the special test and/or needed examination IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 3001 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 3002 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 3003 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
20
Each
EUR____________
EUR________________

Analysis of biological material

(blood or urine) from employees for presence of hazardous substances. These tests will be ordered for employees referred under CLIN 3003 (e.g. Heavy Metal or Benzene series), only if indicated. CLIN will be used per test indicating parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
14
Each
EUR____________
EUR________________

X-ray, set of two pictures

One PA (chest straight ahead) and one left lateral (left side facing screen). This examination will be necessary for those employees who were referred to under CLIN 0003 (Heavy Metal testing), and only if clinically indicated. The appointments will be scheduled IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Tuberculin Test

This test is administered to rule out an explosure to tuberculosis. The exam is included in the unit price IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Color Vision Examination

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
30
Each
EUR____________
EUR________________

Truck Driver Examination

For Class C License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, and perimetrical testing IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
13
Each
EUR____________
EUR________________

Bus Driver Examination

For Class D License. Provided to employees for initial application and at age of 50 and every 5 years thereafter to maintain the license as part of their job requirement. Examination shall include vision acuity, position and motility, color vision, perimetrical testing, and a psychological reaction test IAW the attached PWS.

Total for 3rd Option Period, CLINs 3001 through 3034:

4th Option Period 01 Oct 2019 – 30 Sep 2020, CLINs 4001 through 4034

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
311
Each
EUR____________
EUR________________

Medical Examinations

Period of Performance from 01 October 2019 through 30 September 2020.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
296
Each
EUR____________
EUR________________

Occupational Health Total Examination

Per ArbSchVV to include: health history, physical, clinical examination, vision test, hearing test, pulmonary function test, EKG test, small laboratory, blood count, urinanalysis, Gamma GT and GPT, documentation, diagnosis, and reporting IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
182
Each
EUR____________
EUR________________

Occupational Health Total Examination

With medical-technical and toxicological-analytical parameters not covered under CLIN 0002 (i.e. lead, benzene, toluene) as well as x-ray examination and/or exercise EKG (Ergometry) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Hepatitis A Immunization Initial/Booster

(One single shot as initial or booster to include vaccine, consultation and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
12
Each
EUR____________
EUR________________

Hepatitis A Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Hepatitis B Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
15
Each
EUR____________
EUR________________

Hepatitis B Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
130
Each
EUR____________
EUR________________

Hepatitis AB Immunization Initial/Boost

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
160
Each
EUR____________
EUR________________

Hepatitis AB Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Varicella Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Varicella Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
11
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization

(combination vaccine) (one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

Mumps/Measles/Rubella Immunization Boost

(combination vaccine) (one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Tetanus Immunization Initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
18
Each
EUR____________
EUR________________

Tetanus/Diphteria (Td) Immunization

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
8
Each
EUR____________
EUR________________

FSME Immunization Initial/Booster

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
1
Each
EUR____________
EUR________________

Rabies Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Rabies Immunization Booster

(one single shot as booster) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
2
Each
EUR____________
EUR________________

Pertussius Immunization initial/Booster

(one single shot as initial or booster to include vaccine, consultation, and documentation) IAW the attached PWS, price to be all inclusive (labor, and all material necessary).

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
120
Each
EUR____________
EUR________________

Titer determination

Prior or following an immunization. CLIN will be used per test indicating which parameter tested IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
52
Each
EUR____________
EUR________________

Consultation, Blood Taking, & Doc.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
195
Each
EUR____________
EUR________________

Work site inspections, briefing, safety

Activities related to work area (i.e. work site inspections, briefing, and safety meetings) IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
31
Each
EUR____________
EUR________________

Diagnosis/Examination of reports

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Medical referral to specialist

To complete more extensive testing and evaluation that may not be available from the contractor (i.e. audiologist, optometrist, etc.) The price shall include the special test and/or needed examination IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
10
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 4001 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 4002 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
4
Each
EUR____________
EUR________________

Follow-up Examination

To an Occupational Health Examination as described under CLIN 4003 IAW the attached PWS.

ITEM NO
SUPPLIES/SERVICES
ESTIMATEDQUANTITY
UNIT
UNIT PRICE
ESTIMATED AMOUNT
20
Each
EUR____________
EUR________________

Analysis of biological material

(blood or urine) from employees…

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