FILLABLE TABLE - 75H70723Q00145.docx
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- Solicitation number
- 75H70723Q00145
About this file
This document is a fillable table template for pricing two dental assistants to work at the Zia Health Clinic in Zia Pueblo, New Mexico under solicitation number 75H70723Q00145 issued by the Department of Health and Human Services Indian Health Service. The table includes pricing for an original base period from October 1, 2023 through September 30, 2024 and four one-year option periods extending to September 30, 2028. Offerors are asked to provide an hourly rate for two dental assistants working 40 hours per week for 52 weeks annually, and the table automatically calculates total annual and grand total pricing. Rates must be all-inclusive of expenses such as travel, per diem, lodging, taxes, and other costs.
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Other files
| File | Type | Posted |
|---|---|---|
| EVALUATION FACTORS - DENTAL ASSISTANTS.pdf | ||
| SF-1449 - 75H70723Q00145.pdf | ||
| WAGE DETERMINATION - 2015-5443.pdf |
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Text version
Solicitation No. 75H70723Q00145
2 DENTAL ASSISTANTS
ZIA HEALTH CLINIC
| Item # |
| Contract Period* |
| Pricing per Year** |
| Total Amount |
CLIN 1
| Base Period: 10/01/23 – 09/30/24 |
| 2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year = |
| $___________/year |
| CLIN 2 |
| 1st Option Period: 10/01/24 – 09/30/25 |
| 2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year = |
| $___________/year |
| CLIN 3 |
| 2nd Option Period: 10/01/25 – 09/30/26 |
| 2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year = |
| $___________/year |
| CLIN 4 |
| 3rd Option Period: 10/01/26 – 09/30/27 |
| 2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year = |
| $___________/year |
| CLIN 5 |
| 4th Option Period: 10/01/27 – 09/30/28 |
| 2 Dental Assistants x $________/hour x 40 hours/week x 52 weeks/year = |
| $___________/year |
| GRAND TOTAL (base year + option years): |
| $______________ |
* - Note: Hourly rate shall be an all-inclusive rate of all other fees including: travel expenses; per diem; lodging; all city, state, federal, and local taxes; and miscellaneous cost associated with the above services.
** - You may use a format of your own. Thank you!
File details come from the government source that posted it. Updated .