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Proposed Base Period
| BASE YEAR (PRE-EMPLOYMENT AND EMPLOYEE MEDICAL SERVICES) | | |
| Item No. | Description | Estimated Expected |
| Quantity | Unit | Unit | |
| Price | Total | | |
Estimated $
| 00001 | Pre-employment Medical Services | | |
| A | Pre-employment drug test - all positions | 3084 | each |
| B | Pre-employment onsite drug test - all positions | 1 | each |
| C | Pre-employment modified-onsite drug test - all positions | 1 | each |
| D | Pre-employment medical exam/drug test combination | 1 | each |
| E | Pre-employment medical exam - all positions | 15078 | each |
| F | Chest Xray (single view) | 1056 | each |
| G | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 1584 | each |
| 2 | Non-Psychiatric Level II Consultation | 1584 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 317 | each |
| H | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| I | Physician legal consult/testimony | 8 | per hour |
| J | Physician travel for legal consult/testimony | 6 | per hour |
| K | Travel (i.e.meetings) | 8 | each |
| Pre-Employment Total | | |
| 00002 | Employee Medical Services | | |
| A | Employee medical examination (including physician review) | 150 | each |
| 1 | No show fee for employee medical examination | 8 | each |
| B | IME (including physician review) | 80 | Lot |
| 1 | Rescheduling Fee | 150 | each |
| 2 | No show fee | 20 | each |
| C | Psychiatric IME (including physician review) | 75 | each |
| D | Medical Hardship Reassignment I | 25 | each |
| E | Medical Hardship Reassignment II | 25 | each |
| F | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 50 | each |
| 2 | Non-Psychiatric Level II Consultation | 150 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 200 | each |
| G | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| H | CDL Exams | 48 | each |
| I | Travel (i.e.meetings) | 10 | each |
| J | Physician legal consult/testimony | 50 | per hour |
| K | IME physician legal consult/testimony | 10 | each |
| Employee Services Total | | |
| 00003 | Employee Drug Testing Services | | |
| A | Random on-site | 4500 | each |
| B | Random off-site/ Random network | 1500 | each |
| C | Reasonable Suspicion | 20 | each |
| D | Post Accident (unsafe practice) | 40 | each |
| E | Return-to-duty/follow-up | 50 | each |
| Employee Drug Testing Services Total | | |
| 00004 | Additional Tests | | |
| A | Chest X-Ray (single view) | 5 | each |
| B | TB Skin Test (with chest x-ray if indicated) | 5 | each |
| C | Audiometry | 5 | each |
| D | Height and Weight | 5 | each |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | 5 | each |
| F | Resting EKG with interpretation | 5 | each |
| G | Visual Acuity (Corrected and uncorrected, near and distance) | 5 | each |
| H | Vital Signs | 5 | each |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | 5 | each |
| J | Hemoglobin A1C (HgBA1C) | 5 | each |
| K | Blood Glucose | 5 | each |
| L | Blood Lead Level | 5 | each |
| M | Cardiac Risk Profile | 5 | each |
| N | Chest X-Ray (PA and Lateral) | 5 | each |
| O | Color Vision Assessment | 5 | each |
| P | Maximal Stress EKG with MD interpretation | 5 | each |
| Q | Peripheral Vision and Visual Depth Perception | 5 | each |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | 5 | each |
| S | Resting 12 Lead EKG with MD Interpretation | 5 | each |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | 5 | each |
| U | Blood Alcohol Test | 5 | each |
| V | Exercise Stress Echo | 5 | each |
| W | Echocardiogram | 5 | each |
| X | Sleep study | 5 | each |
| Y | Functional capacity Evaluation (FCE) | 5 | each |
| Z | Additional Testing for IME per Medicare Cost Schedule | 20 | each |
| Additional Tests Total | | |
| 00005 | Information Technology Services | | |
| A | Security Authorization and Monitoring | 1 | each |
| Information Technology Services Total | | |
Base Period Total
Proposed Opt 1
| OPTION PERIOD ONE (PRE-EMPLOYMENT AND EMPLOYEE MEDICAL SERVICES) | | |
| Item No. | Description | Estimated Expected |
| Quantity | Unit | Unit | |
| Price | Total | | |
Estimated $
| 00001 | Pre-employment Medical Services | | |
| A | Pre-employment drug test - all positions | 3084 | each |
| B | Pre-employment onsite drug test - all positions | 1 | each |
| C | Pre-employment modified-onsite drug test - all positions | 1 | each |
| D | Pre-employment medical exam/drug test combination | 1 | each |
| E | Pre-employment medical exam - all positions | 15078 | each |
| F | Chest Xray (single view) | 1056 | each |
| G | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 1584 | each |
| 2 | Non-Psychiatric Level II Consultation | 1584 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 317 | each |
| H | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| I | Physician legal consult/testimony | 8 | per hour |
| J | Physician travel for legal consult/testimony | 6 | per hour |
| K | Travel (i.e.meetings) | 8 | each |
| Pre-Employment Total | | |
| 00002 | Employee Medical Services | | |
| A | Employee medical examination (including physician review) | 150 | each |
| 1 | No show fee for employee medical examination | 8 | each |
| B | IME (including physician review) | 80 | Lot |
| 1 | Rescheduling Fee | 150 | each |
| 2 | No show fee | 20 | each |
| C | Psychiatric IME (including physician review) | 75 | each |
| D | Medical Hardship Reassignment I | 25 | each |
| E | Medical Hardship Reassignment II | 25 | each |
| F | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 50 | each |
| 2 | Non-Psychiatric Level II Consultation | 150 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 200 | each |
| G | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| H | CDL Exams | 48 | each |
| I | Travel (i.e.meetings) | 10 | each |
| J | Physician legal consult/testimony | 50 | per hour |
| K | IME physician legal consult/testimony | 10 | each |
| Employee Services Total | | |
| 00003 | Employee Drug Testing Services | | |
| A | Random on-site | 4500 | each |
| B | Random network | 1500 | each |
| C | Reasonable Suspicion | 20 | each |
| D | Post Accident (unsafe practice) | 40 | each |
| E | Return-to-duty/follow-up | 50 | each |
| Employee Drug Testing Services Total | | |
| 00004 | Additional Tests | | |
| A | Chest X-Ray (single view) | 5 | each |
| B | TB Skin Test (with chest x-ray if indicated) | 5 | each |
| C | Audiometry | 5 | each |
| D | Height and Weight | 5 | each |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | 5 | each |
| F | Resting EKG with interpretation | 5 | each |
| G | Visual Acuity(Corrected and uncorrected, near and distance) | 5 | each |
| H | Vital Signs | 5 | each |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | 5 | each |
| J | Hemoglobin A1C (HgBA1C) | 5 | each |
| K | Blood Glucose | 5 | each |
| L | Blood Lead Level | 5 | each |
| M | Cardiac Risk Profile | 5 | each |
| N | Chest X-Ray (PA and Lateral) | 5 | each |
| O | Color Vision Assessment | 5 | each |
| P | Maximal Stress EKG with MD interpretation | 5 | each |
| Q | Peripheral Vision and Visual Depth Perception | 5 | each |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | 5 | each |
| S | Resting 12 Lead EKG with MD Interpretation | 5 | each |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | 5 | each |
| U | Blood Alcohol Test | 5 | each |
| V | Exercise Stress Echo | 5 | each |
| W | Echocardiogram | 5 | each |
| X | Sleep study | 5 | each |
| Y | Functional capacity Evaluation (FCE) | 5 | each |
| Z | Additional Testing for IME per Medicare Cost Schedule | 20 | each |
| Additional Tests Total | | |
| 00005 | Information Technology Services | | |
| A | Security Authorization and Monitoring | 1 | each |
| Information Technology Services Total | | |
Option Period One Total
Proposed Opt 2
| OPTION PERIOD TWO (PRE-EMPLOYMENT AND EMPLOYEE MEDICAL SERVICES) | | |
| Item No. | Description | Estimated Expected |
| Quantity | Unit | Unit | |
| Price | Total | | |
Estimated $
| 00001 | Pre-employment Medical Services | | |
| A | Pre-employment drug test - all positions | 3251 | each |
| B | Pre-employment onsite drug test - all positions | 1 | each |
| C | Pre-employment modified-onsite drug test - all positions | 1 | each |
| D | Pre-employment medical exam/drug test combination | 1 | each |
| E | Pre-employment medical exam - all positions | 14570 | each |
| F | Chest Xray (single view) | 1166 | each |
| G | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 897 | each |
| 2 | Non-Psychiatric Level II Consultation | 897 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 180 | each |
| H | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| I | Physician legal consult/testimony | 8 | per hour |
| J | Physician travel for legal consult/testimony | 6 | per hour |
| K | Travel (i.e.meetings) | 8 | each |
| Pre-Employment Total | | |
| 00002 | Employee Medical Services | | |
| A | Employee medical examination (including physician review) | 150 | each |
| 1 | No show fee for employee medical examination | 8 | each |
| B | IME (including physician review) | 80 | Lot |
| 1 | Rescheduling Fee | 150 | each |
| 2 | No show fee | 20 | each |
| C | Psychiatric IME (including physician review) | 75 | each |
| D | Medical Hardship Reassignment I | 25 | each |
| E | Medical Hardship Reassignment II | 25 | each |
| F | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 50 | each |
| 2 | Non-Psychiatric Level II Consultation | 150 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 200 | each |
| G | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| H | CDL Exams | 48 | each |
| I | Travel (i.e.meetings) | 10 | each |
| J | Physician legal consult/testimony | 50 | per hour |
| K | IME physician legal consult/testimony | 10 | each |
| Employee Services Total | | |
| 00003 | Employee Drug Testing Services | | |
| A | Random on-site | 4500 | each |
| B | Random network | 1500 | each |
| C | Reasonable Suspicion | 20 | each |
| D | Post Accident (unsafe practice) | 40 | each |
| E | Return-to-duty/follow-up | 50 | each |
| Employee Drug Testing Services Total | | |
| 00004 | Additional Tests | | |
| A | Chest X-Ray (single view) | 5 | each |
| B | TB Skin Test (with chest x-ray if indicated) | 5 | each |
| C | Audiometry | 5 | each |
| D | Height and Weight | 5 | each |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | 5 | each |
| F | Resting EKG with interpretation | 5 | each |
| G | Visual Acuity(Corrected and uncorrected, near and distance) | 5 | each |
| H | Vital Signs | 5 | each |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | 5 | each |
| J | Hemoglobin A1C (HgBA1C) | 5 | each |
| K | Blood Glucose | 5 | each |
| L | Blood Lead Level | 5 | each |
| M | Cardiac Risk Profile | 5 | each |
| N | Chest X-Ray (PA and Lateral) | 5 | each |
| O | Color Vision Assessment | 5 | each |
| P | Maximal Stress EKG with MD interpretation | 5 | each |
| Q | Peripheral Vision and Visual Depth Perception | 5 | each |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | 5 | each |
| S | Resting 12 Lead EKG with MD Interpretation | 5 | each |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | 5 | each |
| U | Blood Alcohol Test | 5 | each |
| V | Exercise Stress Echo | 5 | each |
| W | Echocardiogram | 5 | each |
| X | Sleep study | 5 | each |
| Y | Functional capacity Evaluation (FCE) | 5 | each |
| Z | Additional Testing for IME per Medicare Cost Schedule | 20 | each |
| Additional Tests Total | | |
| 00005 | Information Technology Services | | |
| A | Security Authorization and Monitoring | 1 | each |
| Information Technology Services Total | | |
Option Period Two Total
Proposed Opt 3
| OPTION PERIOD THREE (PRE-EMPLOYMENT AND EMPLOYEE MEDICAL SERVICES) | | |
| Item No. | Description | Estimated Expected |
| Quantity | Unit | Unit | |
| Price | Total | | |
Estimated $
| 00001 | Pre-employment Medical Services | | |
| A | Pre-employment drug test - all positions | 3251 | each |
| B | Pre-employment onsite drug test - all positions | 1 | each |
| C | Pre-employment modified-onsite drug test - all positions | 1 | each |
| D | Pre-employment medical exam/drug test combination | 1 | each |
| E | Pre-employment medical exam - all positions | 14570 | each |
| F | Chest Xray (single view) | 1166 | each |
| G | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 897 | each |
| 2 | Non-Psychiatric Level II Consultation | 897 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 180 | each |
| H | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| I | Physician legal consult/testimony | 8 | per hour |
| J | Physician travel for legal consult/testimony | 6 | per hour |
| K | Travel (i.e.meetings) | 8 | each |
| Pre-Employment Total | | |
| 00002 | Employee Medical Services | | |
| A | Employee medical examination (including physician review) | 150 | each |
| 1 | No show fee for employee medical examination | 8 | each |
| B | IME (including physician review) | 80 | Lot |
| 1 | Rescheduling Fee | 150 | each |
| 2 | No show fee | 20 | each |
| C | Psychiatric IME (including physician review) | 75 | each |
| D | Medical Hardship Reassignment I | 25 | each |
| E | Medical Hardship Reassignment II | 25 | each |
| F | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 50 | each |
| 2 | Non-Psychiatric Level II Consultation | 150 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 200 | each |
| G | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| H | CDL Exams | 48 | each |
| I | Travel (i.e.meetings) | 10 | each |
| J | Physician legal consult/testimony | 50 | per hour |
| K | IME physician legal consult/testimony | 10 | each |
| Employee Services Total | | |
| 00003 | Employee Drug Testing Services | | |
| A | Random on-site | 4500 | each |
| B | Random network | 1500 | each |
| C | Reasonable Suspicion | 20 | each |
| D | Post Accident (unsafe practice) | 40 | each |
| E | Return-to-duty/follow-up | 50 | each |
| Employee Drug Testing Services Total | | |
| 00004 | Additional Tests | | |
| A | Chest X-Ray (single view) | 5 | each |
| B | TB Skin Test (with chest x-ray if indicated) | 5 | each |
| C | Audiometry | 5 | each |
| D | Height and Weight | 5 | each |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | 5 | each |
| F | Resting EKG with interpretation | 5 | each |
| G | Visual Acuity(Corrected and uncorrected, near and distance) | 5 | each |
| H | Vital Signs | 5 | each |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | 5 | each |
| J | Hemoglobin A1C (HgBA1C) | 5 | each |
| K | Blood Glucose | 5 | each |
| L | Blood Lead Level | 5 | each |
| M | Cardiac Risk Profile | 5 | each |
| N | Chest X-Ray (PA and Lateral) | 5 | each |
| O | Color Vision Assessment | 5 | each |
| P | Maximal Stress EKG with MD interpretation | 5 | each |
| Q | Peripheral Vision and Visual Depth Perception | 5 | each |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | 5 | each |
| S | Resting 12 Lead EKG with MD Interpretation | 5 | each |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | 5 | each |
| U | Blood Alcohol Test | 5 | each |
| V | Exercise Stress Echo | 5 | each |
| W | Echocardiogram | 5 | each |
| X | Sleep study | 5 | each |
| Y | Functional capacity Evaluation (FCE) | 5 | each |
| Z | Additional Testing for IME per Medicare Cost Schedule | 20 | each |
| Additional Tests Total | | |
| 00005 | Information Technology Services | | |
| A | Security Authorization and Monitoring | 1 | each |
| Information Technology Services | | |
Option Period Three Total
Proposed Opt 4
| OPTION PERIOD FOUR (PRE-EMPLOYMENT AND EMPLOYEE MEDICAL SERVICES) | | |
| Item No. | Description | Estimated Expected |
| Quantity | Unit | Unit | |
| Price | Total | | |
Estimated $
| 00001 | Pre-employment Medical Services | | |
| A | Pre-employment drug test - all positions | 3251 | each |
| B | Pre-employment onsite drug test - all positions | 1 | each |
| C | Pre-employment modified-onsite drug test - all positions | 1 | each |
| D | Pre-employment medical exam/drug test combination | 1 | each |
| E | Pre-employment medical exam - all positions | 14570 | each |
| F | Chest Xray (single view) | 1166 | each |
| G | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 897 | each |
| 2 | Non-Psychiatric Level II Consultation | 897 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 180 | each |
| H | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| I | Physician legal consult/testimony | 8 | per hour |
| J | Physician travel for legal consult/testimony | 6 | per hour |
| K | Travel (i.e.meetings) | 8 | each |
| Pre-Employment Total | | |
| 00002 | Employee Medical Services | | |
| A | Employee medical examination (including physician review) | 150 | each |
| 1 | No show fee for employee medical examination | 8 | each |
| B | IME (including physician review) | 80 | Lot |
| 1 | Rescheduling Fee | 150 | each |
| 2 | No show fee | 20 | each |
| C | Psychiatric IME (including physician review) | 75 | each |
| D | Medical Hardship Reassignment I | 25 | each |
| E | Medical Hardship Reassignment II | 25 | each |
| F | Non-Psychiatric Consultation | | |
| 1 | Non-Psychiatric Level I Consultation | 50 | each |
| 2 | Non-Psychiatric Level II Consultation | 150 | each |
| 3 | Non-Psychiatric Level III Specialist Consultation | 200 | each |
| G | Psychiatric Specialist Consultation - all positions | | |
| 1 | Psychiatric Level I Consultation | 1 | each |
| 2 | Psychiatric Level II Consultation | 1 | each |
| 3 | Psychiatric Level III Consultation | 1 | each |
| H | CDL Exams | 48 | each |
| I | Travel (i.e.meetings) | 10 | each |
| J | Physician legal consult/testimony | 50 | per hour |
| K | IME physician legal consult/testimony | 10 | each |
| Employee Services Total | | |
| 00003 | Employee Drug Testing Services | | |
| A | Random on-site | 4500 | each |
| B | Random network | 1500 | each |
| C | Reasonable Suspicion | 20 | each |
| D | Post Accident (unsafe practice) | 40 | each |
| E | Return-to-duty/follow-up | 50 | each |
| Employee Drug Testing Services Total | | |
| 00004 | Additional Tests | | |
| A | Chest X-Ray (single view) | 5 | each |
| B | TB Skin Test (with chest x-ray if indicated) | 5 | each |
| C | Audiometry | 5 | each |
| D | Height and Weight | 5 | each |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | 5 | each |
| F | Resting EKG with interpretation | 5 | each |
| G | Visual Acuity(Corrected and uncorrected, near and distance) | 5 | each |
| H | Vital Signs | 5 | each |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | 5 | each |
| J | Hemoglobin A1C (HgBA1C) | 5 | each |
| K | Blood Glucose | 5 | each |
| L | Blood Lead Level | 5 | each |
| M | Cardiac Risk Profile | 5 | each |
| N | Chest X-Ray (PA and Lateral) | 5 | each |
| O | Color Vision Assessment | 5 | each |
| P | Maximal Stress EKG with MD interpretation | 5 | each |
| Q | Peripheral Vision and Visual Depth Perception | 5 | each |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | 5 | each |
| S | Resting 12 Lead EKG with MD Interpretation | 5 | each |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | 5 | each |
| U | Blood Alcohol Test | 5 | each |
| V | Exercise Stress Echo | 5 | each |
| W | Echocardiogram | 5 | each |
| X | Sleep study | 5 | each |
| Y | Functional capacity Evaluation (FCE) | 5 | each |
| Z | Additional Testing for IME per Medicare Cost Schedule | 20 | each |
| Additional Tests Total | | |
| 00005 | Information Technology Services | | |
| A | Security Authorization and Monitoring | 1 | each |
| Information Technology Services Total | | |
Option Period Four Total
Base + 4 Opt Unit $
UNIT PRICE
BASE YEAR + 4 OPTIONS MEDICAL SERVICES
| Item No. | Description | Unit | Est Base Period | Est |
| Opt 1 | Est | | | | |
| Opt 2 | Est | | | | |
| Opt 3 | Est | | | | |
Opt 4
| 00001 | Pre-employment Medical Services | | | | | | |
| A | Pre-employment drug test - all positions | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| B | Pre-employment onsite drug test - all positions | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| C | Pre-employment modified-onsite drug test - all positions | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| D | Pre-employment medical exam/drug test combination | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| E | Pre-employment medical exam - all positions | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| F | Chest Xray (single view) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| G | Non-Psychiatric Consultation | | | | | | |
| 1 | Non-Psychiatric Level I Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 2 | Non-Psychiatric Level II Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 3 | Non-Psychiatric Level III Specialist Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| H | Psychiatric Specialist Consultation - all positions | | | | | | |
| 1 | Psychiatric Level I Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 2 | Psychiatric Level II Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 3 | Psychiatric Level III Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| I | Physician legal consult/testimony | per hour | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| J | Physician travel for legal consult/testimony | per hour | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| K | Travel (i.e.meetings) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 00002 | Employee Medical Services | | | | | | |
| A | Employee medical examination (including physician review) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 1 | No show fee for employee medical examination | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| B | IME (including physician review) | Lot | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 1 | Rescheduling Fee | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 2 | No show fee | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| C | Psychiatric IME (including physician review) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| D | Compassionate Transfer/Hardship Requests I | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| E | Compassionate Transfer/Hardship Requests II | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| F | Non-Psychiatric Consultation | | | | | | |
| 1 | Non-Psychiatric Level I Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 2 | Non-Psychiatric Level II Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 3 | Non-Psychiatric Level III Specialist Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| G | Psychiatric Specialist Consultation - all positions | | | | | | |
| 1 | Psychiatric Level I Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 2 | Psychiatric Level II Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 3 | Psychiatric Level III Consultation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| H | CDL Exams | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| I | Travel (i.e.meetings) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| J | Physician legal consult/testimony | per hour | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| K | IME physician legal consult/testimony | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 00003 | Employee Drug Testing Services | | | | | | |
| A | Random on-site | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| B | Random off-site/ Random network | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| C | Reasonable Suspicion | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| D | Post Accident (unsafe practice) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| E | Return-to-duty/follow-up | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 00004 | Additional Tests | | | | | | |
| A | Chest X-Ray (single view) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| B | TB Skin Test (with chest x-ray if indicated) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| C | Audiometry | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| D | Height and Weight | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| F | Resting EKG with interpretation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| G | Visual Acuity (Corrected and uncorrected, near and distance) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| H | Vital Signs | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| J | Hemoglobin A1C (HgBA1C) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| K | Blood Glucose | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| L | Blood Lead Level | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| M | Cardiac Risk Profile | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| N | Chest X-Ray (PA and Lateral) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| O | Color Vision Assessment | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| P | Maximal Stress EKG with MD interpretation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Q | Peripheral Vision and Visual Depth Perception | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| S | Resting 12 Lead EKG with MD Interpretation | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| U | Blood Alcohol Test | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| V | Exercise Stress Echo | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| W | Echocardiogram | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| X | Sleep study | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Y | Functional capacity Evaluation (FCE) | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Z | Additional Testing for IME per Medicare Cost Schedule | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| 00005 | Information Technology Services | | | | | | |
| A | Security Authorization and Monitoring | each | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Base + 4 Opt $ Summary
| Base Period + 4 Option Years | |
| Each CLIN | | Base Period + 4 Option Years |
All CLINs Combined
| Period & CLIN | Estimated Price | Period | Estimated Price |
| 00001 | Pre-employment Medical Services | Base Period | $0.00 |
| Base Period | $0.00 | Option Period #1 | $0.00 |
| Option Period #1 | $0.00 | Option Period #2 | $0.00 |
| Option Period #2 | $0.00 | Option Period #3 | $0.00 |
| Option Period #3 | $0.00 | Option Period #4 | $0.00 |
| Option Period #4 | $0.00 | Whole Contract Total | $0.00 |
| 00001 Total | $0.00 | | |
| 00002 | Employee Medical Services | Volume based on historical trends and expected volume |
| Base Period | $0.00 | |
| Option Period #1 | $0.00 | |
| Option Period #2 | $0.00 | |
| Option Period #3 | $0.00 | |
| Option Period #4 | $0.00 | |
| 00002 Total | $0.00 | |
| 00003 | Employee Drug Testing Services |
| Base Period | $0.00 |
| Option Period #1 | $0.00 |
| Option Period #2 | $0.00 |
| Option Period #3 | $0.00 |
| Option Period #4 | $0.00 |
| 00003 Total | $0.00 |
| 00004 | Additional Tests |
| Base Period | $0.00 |
| Option Period #1 | $0.00 |
| Option Period #2 | $0.00 |
| Option Period #3 | $0.00 |
| Option Period #4 | $0.00 |
| 00004 Total | $0.00 |
| 00005 | Information Technology Services |
| Base Period | $0.00 |
| Option Period #1 | $0.00 |
| Option Period #2 | $0.00 |
| Option Period #3 | $0.00 |
| Option Period #4 | $0.00 |
| 00005 Total | $0.00 |
Base + 4 Opt Qty
QUANTITIES
BASE YEAR + 4 OPTIONS MEDICAL SERVICES
| Item No. | Description | Unit | Est Base Period | Est |
| Opt 1 | Est | | | | |
| Opt 2 | Est | | | | |
| Opt 3 | Est | | | | |
| Opt 4 | Est | | | | |
Total
| 00001 | Pre-employment Medical Services | | | | | | | |
| A | Pre-employment drug test - all positions | each | 3,084 | 3,084 | 3,251 | 3,251 | 3,251 | 15,921 |
| B | Pre-employment onsite drug test - all positions | each | 1 | 1 | 1 | 1 | 1 | 5 |
| C | Pre-employment modified-onsite drug test - all positions | each | 1 | 1 | 1 | 1 | 1 | 5 |
| D | Pre-employment medical exam/drug test combination | each | 1 | 1 | 1 | 1 | 1 | 5 |
| E | Pre-employment medical exam - all positions | each | 15,078 | 15,078 | 14,570 | 14,570 | 14,570 | 73,866 |
| F | Chest Xray (single view) | each | 1,056 | 1,056 | 1,166 | 1,166 | 1,166 | 5,610 |
| G | Non-Psychiatric Consultation | | | | | | | |
| 1 | Non-Psychiatric Level I Consultation | each | 1,584 | 1,584 | 897 | 897 | 897 | 5,859 |
| 2 | Non-Psychiatric Level II Consultation | each | 1,584 | 1,584 | 897 | 897 | 897 | 5,859 |
| 3 | Non-Psychiatric Level III Specialist Consultation | each | 317 | 317 | 180 | 180 | 180 | 1,174 |
| H | Psychiatric Specialist Consultation - all positions | | | | | | | |
| 1 | Psychiatric Level I Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| 2 | Psychiatric Level II Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| 3 | Psychiatric Level III Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| I | Physician legal consult/testimony | per hour | 8 | 8 | 8 | 8 | 8 | 40 |
| J | Physician travel for legal consult/testimony | per hour | 6 | 6 | 6 | 6 | 6 | 30 |
| K | Travel (i.e.meetings) | each | 8 | 8 | 8 | 8 | 8 | 40 |
| Pre-Employment Estimated Total | | 22,731 | 22,731 | 20,989 | 20,989 | 20,989 | 108,429 |
| 00002 | Employee Medical Services | | | | | | | |
| A | Employee medical examination (including physician review) | each | 150 | 150 | 150 | 150 | 150 | 750 |
| 1 | No show fee for employee medical examination | each | 8 | 8 | 8 | 8 | 8 | 40 |
| B | IME (including physician review) | Lot | 80 | 80 | 80 | 80 | 80 | 400 |
| 1 | Rescheduling Fee | each | 150 | 150 | 150 | 150 | 150 | 750 |
| 2 | No show fee | each | 20 | 20 | 20 | 20 | 20 | 100 |
| C | Psychiatric IME (including physician review) | each | 75 | 75 | 75 | 75 | 75 | 375 |
| D | Medical Hardship Reassignment I | each | 25 | 25 | 25 | 25 | 25 | 125 |
| E | Medical Hardship Reassignment II | each | 25 | 25 | 25 | 25 | 25 | 125 |
| F | Non-Psychiatric Consultation | | | | | | | |
| 1 | Non-Psychiatric Level I Consultation | each | 50 | 50 | 50 | 50 | 50 | 250 |
| 2 | Non-Psychiatric Level II Consultation | each | 150 | 150 | 150 | 150 | 150 | 750 |
| 3 | Non-Psychiatric Level III Specialist Consultation | each | 200 | 200 | 200 | 200 | 200 | 1,000 |
| G | Psychiatric Specialist Consultation - all positions | | | | | | | |
| 1 | Psychiatric Level I Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| 2 | Psychiatric Level II Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| 3 | Psychiatric Level III Consultation | each | 1 | 1 | 1 | 1 | 1 | 5 |
| H | CDL Exams | each | 48 | 48 | 48 | 48 | 48 | 240 |
| I | Travel (i.e.meetings) | each | 10 | 10 | 10 | 10 | 10 | 50 |
| J | Physician legal consult/testimony | per hour | 50 | 50 | 50 | 50 | 50 | 250 |
| K | IME physician legal consult/testimony | each | 10 | 10 | 10 | 10 | 10 | 50 |
| Employee Services Estimated Total | | 1,054 | 1,054 | 1,054 | 1,054 | 1,054 | 5,270 |
| 00003 | Employee Drug Testing Services | | | | | | | |
| A | Random on-site | each | 4,500 | 4,500 | 4,500 | 4,500 | 4,500 | 22,500 |
| B | Random off-site/ Random network | each | 1,500 | 1,500 | 1,500 | 1,500 | 1,500 | 7,500 |
| C | Reasonable Suspicion | each | 20 | 20 | 20 | 20 | 20 | 100 |
| D | Post Accident (unsafe practice) | each | 40 | 40 | 40 | 40 | 40 | 200 |
| E | Return-to-duty/follow-up | each | 50 | 50 | 50 | 50 | 50 | 250 |
| Employee Drug Testing Services Estimated Total | | 6,110 | 6,110 | 6,110 | 6,110 | 6,110 | 30,550 |
| 00004 | Additional Tests | | | | | | | |
| A | Chest X-Ray (single view) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| B | TB Skin Test (with chest x-ray if indicated) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| C | Audiometry | each | 5 | 5 | 5 | 5 | 5 | 25 |
| D | Height and Weight | each | 5 | 5 | 5 | 5 | 5 | 25 |
| E | Lab Profile: CBC with differential, CHEM profile, Urinalysis | each | 5 | 5 | 5 | 5 | 5 | 25 |
| F | Resting EKG with interpretation | each | 5 | 5 | 5 | 5 | 5 | 25 |
| G | Visual Acuity (Corrected and uncorrected, near and distance) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| H | Vital Signs | each | 5 | 5 | 5 | 5 | 5 | 25 |
| I | Thyroid Stimulating Hormone (TSH) w/Reflex Free T4 | each | 5 | 5 | 5 | 5 | 5 | 25 |
| J | Hemoglobin A1C (HgBA1C) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| K | Blood Glucose | each | 5 | 5 | 5 | 5 | 5 | 25 |
| L | Blood Lead Level | each | 5 | 5 | 5 | 5 | 5 | 25 |
| M | Cardiac Risk Profile | each | 5 | 5 | 5 | 5 | 5 | 25 |
| N | Chest X-Ray (PA and Lateral) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| O | Color Vision Assessment | each | 5 | 5 | 5 | 5 | 5 | 25 |
| P | Maximal Stress EKG with MD interpretation | each | 5 | 5 | 5 | 5 | 5 | 25 |
| Q | Peripheral Vision and Visual Depth Perception | each | 5 | 5 | 5 | 5 | 5 | 25 |
| R | Protoporphyrin, Zinc (ZPP) Blood Test | each | 5 | 5 | 5 | 5 | 5 | 25 |
| S | Resting 12 Lead EKG with MD Interpretation | each | 5 | 5 | 5 | 5 | 5 | 25 |
| T | Spirometry (FVC%, FEV1, FEV1/FVC%) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| U | Blood Alcohol Test | each | 5 | 5 | 5 | 5 | 5 | 25 |
| V | Exercise Stress Echo | each | 5 | 5 | 5 | 5 | 5 | 25 |
| W | Echocardiogram | each | 5 | 5 | 5 | 5 | 5 | 25 |
| X | Sleep study | each | 5 | 5 | 5 | 5 | 5 | 25 |
| Y | Functional capacity Evaluation (FCE) | each | 5 | 5 | 5 | 5 | 5 | 25 |
| Z | Additional Testing for IME per Medicare Cost Schedule | each | 20 | 20 | 20 | 20 | 20 | 100 |
| Additional Tests Estimated Total | | 145 | 145 | 145 | 145 | 145 | 725 |
| 00005 | Information Technology Services | | | | | | | |
| A | Security Authorization and Monitoring | each | 1 | 1 | 1 | 1 | 1 | 5 |
| Information Technology Estimated Total | | 1 | 1 | 1 | 1 | 1 | 5 |
