Final_ARFQ_0512_WEH2600000012_1_WV_ARFQ_FORM.PDF
PDF 734 KB Posted
- Solicitation number
- ARFQ 0512 WEH2600000012 1
- Issued by
- Mineral County, West Virginia
About this file
This is an Agency Request for Quote (ARFQ) form issued by the West Virginia Office of Shared Administration (WVOSA) Purchasing Division on behalf of the Department of Health Facilities at Welch Community Hospital. The solicitation seeks bids to establish a physician services contract for specialty services in Obstetrics and Gynecology, providing OB/GYN physician coverage for clinic work at Welch Community Hospital located at 454 McDowell Street in Welch, West Virginia. The request includes three line items: OB/GYN Physician Clinic Services (80 days), Mid-Level Practitioner services (76 days), and an Administration Fee (12 months). The solicitation was issued on March 10, 2026, with a closing date of March 31, 2026, at 11:00 AM. Questions from potential bidders are due by March 18, 2026, at 10:30 AM EST. Interested vendors should direct inquiries to Roberta A. Wagner, the designated buyer, at (304) 558-0437 or roberta.a.wagner@wv.gov. Bids should be submitted to the Office of Shared Administration Operations/Purchasing at One Davis Square, First Floor, Room 107, Charleston, West Virginia 25301.
This solicitation is covered in part or in whole by federal funds, requiring all bidders to acknowledge and adhere to the attached Federal Funds Addendum. No specific pricing, contract term length, or renewal options are detailed in this form, as the request is for quote submission. The State has developed an Equal Employment Opportunity (EEO) Utilization Report available for reference. Vendors must submit their FEIN (Federal Employer Identification Number) and principal contact information as part of their bid response. All offers are subject to the terms and conditions contained in the complete solicitation documents.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit E 482.30 Condition of Participation - Utilization Review.pdf | ||
| Exhibit A Pricing Page..pdf | ||
| Specifications.docx | DOCX document | |
| TCA.pdf | ||
| Exhibit D Stark Law.pdf | ||
| Federal Funds Addendum.pdf | ||
| Exhibit B Medical Staff Bylaws.pdf | ||
| WV HIPAA BAA.pdf | ||
| PAffidavit.pdf | ||
| WV43-WV36.pdf | ||
| Exhibit C Policy 3501A.pdf |
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Text version
Date Printed: Mar 10, 2026 Page:1 FORM ID: WV-PRC-ARFQ-002 2020/05
State of West Virginia Agency Request for Quote
Service - Prof
Proc Folder: 1906106 Reason for Modification:
Doc Description: OB/GYN (Obstetrician-Gynecologist) Physician Clinic Services
Proc Type: Agency Master Agreement
Date Issued Solicitation Closes Solicitation No Version
2026-03-10 2026-03-31 11:00 ARFQ 0512 WEH2600000012 1
BID RECEIVING LOCATION
BUYER - 304-957-0209
OFFICE OF SHARED ADMINISTRATION
OPERATIONS/PURCHASING
ONE DAVIS SQUARE, FIRST FLOOR RM 107
CHARLESTON WV 25301
US
VENDOR
Vendor Customer Code:
Vendor Name :
Address :
Street :
City :
State : Country : Zip :
Principal Contact :
Vendor Contact Phone: Extension:
FOR INFORMATION CONTACT THE BUYER
Roberta A Wagner
(304) 558-0437 roberta.a.wagner@wv.gov
Vendor Signature X FEIN# DATE All offers subject to all terms and conditions contained in this solicitation
Date Printed: Mar 10, 2026 Page:2 FORM ID: WV-PRC-ARFQ-002 2020/05
ADDITIONAL INFORMATION
The West Virginia Office of Shared Administration (WVOSA), Purchasing Division is soliciting bids on behalf of The Department of Health Facilities, Welch Community Hospital (Agency) to establish a physician services contract for specialty services in the areas of Obstetrics (OB)/Gynecology (GYN) to provide OB/GYN physicians services providing coverage for clinic work at Welch Community Hospital.
NOTE: This request is covered in part or in whole by federal funds. All bidders will be required to acknowledge and adhere to the attached Federal Funds Addendum.
NOTE: The DoHS OSA has developed an EEOP Utilization Report, and it is available at:
https://dhhr.wv.gov/office-of-drug-control-policy/news/Documents/EEO%20Uitlization%20Report%20Completed%20Form
%201-29-21-final-PDF%20review%20for%20approval%20to%20submit%20%283%29.pdf
INVOICE TO SHIP TO
HEALTH AND HUMAN
RESOURCES
HEALTH AND HUMAN
RESOURCES
WELCH COMMUNITY
HOSPITAL
WELCH COMMUNITY
HOSPITAL
454 MCDOWELL ST 454 MCDOWELL ST
WELCH WV WELCH WV
US US
Line Comm Ln Desc Qty Unit Issue Unit Price Total Price 1 OB/GYN Physician Clinic Services 80.00000 DAY
Comm Code Manufacturer Specification Model # 85121601
Extended Description:
OB/GYN Physician Services 4.1.2.1
Date Printed: Mar 10, 2026 Page:3 FORM ID: WV-PRC-ARFQ-002 2020/05
INVOICE TO SHIP TO
HEALTH AND HUMAN
RESOURCES
HEALTH AND HUMAN
RESOURCES
WELCH COMMUNITY
HOSPITAL
WELCH COMMUNITY
HOSPITAL
454 MCDOWELL ST 454 MCDOWELL ST
WELCH WV WELCH WV
US US
Line Comm Ln Desc Qty Unit Issue Unit Price Total Price 2 Mid-Level Practitioner 76.00000 DAY
Comm Code Manufacturer Specification Model # 85121601
Extended Description:
Mid-Level Practitioner 4.1.2.2
INVOICE TO SHIP TO
HEALTH AND HUMAN
RESOURCES
HEALTH AND HUMAN
RESOURCES
WELCH COMMUNITY
HOSPITAL
WELCH COMMUNITY
HOSPITAL
454 MCDOWELL ST 454 MCDOWELL ST
WELCH WV WELCH WV
US US
Line Comm Ln Desc Qty Unit Issue Unit Price Total Price 3 Administration Fee 12.00000 MO
Comm Code Manufacturer Specification Model # 85121601
Extended Description:
Administration Fee
SCHEDULE OF EVENTS
Line Event Event Date 1 Questions are due by 10:30 AM EST 2026-03-18
Document Phase Document Description Page
WEH2600000012 Final OB/GYN (Obstetrician-Gynecologist) Physician Clinic Services
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