FILLABLE TABLE - 75H70724Q00080.docx
DOCX document 22 KB Posted
- Solicitation number
- 75H70724Q00080
About this file
This document is a solicitation (Request for Quotes) for Clearinghouse Services for the Albuquerque Service Unit of the Indian Health Service (IHS). The solicitation number is 75H70724Q00080 and the NAICS code is 522320 with a $47.0M small business size standard.
The solicitation is being issued as a cascading set-aside, with the first tier being Indian Small Business Economic Enterprises (ISBEEs), followed by all other small businesses and then large businesses, if sufficient competition is not received from the ISBEE set-aside. Proposals are due by 5:30 pm MDT on May 28, 2024 and must be valid for at least 90 days. The contract period is for a base year from December 1, 2024 to November 30, 2025, with four one-year option periods. Pricing is requested to be provided in the attached fillable pricing table. Vendors must be registered in SAM and have an active UEI number to be eligible for award. Payment will be made via electronic funds transfer.
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Other files
| File | Type | Posted |
|---|---|---|
| SOLICITATION 75H70724Q00080.pdf | ||
| Business Associate Agreement.pdf | ||
| IHS IEE Representation Form_Jan 2022_508 Compliant.pdf |
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Text version
Clearinghouse Services Solicitation No. 75H70724Q00080 Albuquerque Service Unit
| Item # |
| Contract Period |
| Pricing per Year |
| Total Amount |
CLIN 1
| Base Year: 12/01/2024 – 11/30/2025 |
| $________/month x 12 months/year = |
| $__________/year |
| CLIN 2 |
| 1st Option Year: 12/01/2025 – 11/30/2026 |
| $________/month x 12 months/year = |
| $__________/year |
| CLIN 3 |
| 2nd Option Year: 12/01/2026 – 11/30/2027 |
| $________/month x 12 months/year = |
| $__________/year |
| CLIN 4 |
| 3rd Option Year: 12/01/2027 – 11/30/2028 |
| $________/month x 12 months/year = |
| $__________/year |
| CLIN 5 |
| 4th Option Year: 12/01/2028 – 11/30/2029 |
| $________/month x 12 months/year = |
| $__________/year |
| GRAND TOTAL (base year + option years): |
| $__________/year |
* - You may use this fillable table or a format of your own. Thank you!
File details come from the government source that posted it. Updated .