Attachment_2-Pricing_Schedule_TW_3.27.17.xlsx

XLSX spreadsheet 37 KB Posted

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Medical, Psychological, Fitness and Drug Testing
Solicitation number
HSCEMD-17-R-00001
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Pricing Schedule

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Questions_and_Answers_Consolidated_2.pdf PDF
Section_C__E_HSCEMD-17-R-00001_4.13.17_with_Track_Changes_Cont.docx DOCX document
Section_C__E_HSCEMD-17-R-00001_4.21.17_Final_Version.pdf PDF
Attachment_2-Pricing_Schedule_4.13.17.xlsx XLSX spreadsheet
Attachment_1_-_Performance_Work_Statement_4.13.17_with_Track_Changes.docx DOCX document
Section_C__E_HSCEMD-17-R-00001_4.13.17_with_Track_Changes.docx DOCX document
Questions_and_Answers_Consolidated.docx DOCX document
Attachment_1_-_Performance_Work_Statement.pdf PDF
Appendix_K_Redacted_Medical_Follow_Up_Letter_-_Example.pdf PDF
Appendix_L_-_Fitness_Audio.mp3 MP3 file
Appendix_F_ICE_Deportation_Officer_Fitness_Test_Scoresheet_updated.pdf PDF
Appendix_I_-_Cities_Requiring_50_Miles.pdf PDF
Appendix_G_November_2016_-_List_of_Certified_Laboratories.pdf PDF
Appendix_E_ICE_Personnel_-_Duty_Locations.pdf PDF
Section_C__E_HSCEMD-17-R-00001.pdf PDF
Attachment_4_-Contractor_Performance_Eval_Survey.docx DOCX document
HSCEMD-17-R-00001_1449.pdf PDF
Attachment_2-Pricing_Schedule.xlsx XLSX spreadsheet
Appendix_D_Drug_Free_Plan.pdf PDF
Appendix_B_DOJ_Medical_Standards_1999.pdf PDF
Appendix_H_5_CFR_339_Medical_Qualifications_Jan_2017.pdf PDF
Appendix_A_specimen-collection-handbook-2014.pdf PDF
Attachment_5_-_List_of_Appendices.pdf PDF
Attachment_3-_Questions_and_Comments_Template.docx DOCX document
Appendix_J_Redacted_Medical_Report_Summary_-_Example.pdf PDF
Appendix_C_Medical_Review_Officer_Manual.pdf PDF
Attachment_5_-_List_of_Appendices_TW_3.27.17.docx DOCX document
Appendix_K_Redacted_Medical_Follow_Up_Letter_-_Example.pdf PDF
Section_C__E_HSCEMD-17-R-00001_with_Track_Changes.docx DOCX document
Questions_and_Answers.pdf PDF
Performance_Work_Statement_-_with_Track_Changes.docx DOCX document
Attachment_5_-_List_of_Appendices.pdf PDF
Section_C__E_HSCEMD-17-R-00001_DRAFT_3.16.17.pdf PDF
Fitness_Audio.mp3 MP3 file
Appendix_A_specimen-collection-handbook-2014.pdf PDF
Appendix_H_5_CFR_339_Medical_Qualifications_Jan_2017.pdf PDF
Attachment_1_-_Performance_Work_Statement_-DRAFT-_3.15.17.pdf PDF
Appendix_D_Drug_Free_Plan.pdf PDF
Appendix_I_-_Cities_Requiring_50_Miles.pdf PDF
Attachment_2-Pricing_Schedule_DRAFT.xlsx XLSX spreadsheet
Attachment_4_-Contractor_Performance_Eval_Survey.docx DOCX document
Appendix_G_November_2016_-_List_of_Certified_Laboratories.pdf PDF
Attachment_3-_Questions_and_Comments_Template.docx DOCX document
Appendix_E_ICE_Personnel_-_Duty_Locations.pdf PDF
Appendix_F_ICE_Deportation_Officer_Fitness_Test_Scoresheet_updated.pdf PDF
Appendix_B_DOJ_Medical_Standards_1999.pdf PDF
Appendix_C_Medical_Review_Officer_Manual.pdf PDF
Synopsis_-_HSCEMD-17-R-00001.pdf PDF
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Schedule

Estimated Period of PerformancePeriod 17/1/176/30/18Period 27/1/186/30/19Period 37/1/196/30/20Period 47/1/206/30/21Period 57/1/216/30/22-8 Ext7/1/221/1/2366 Month Total
Item No.Supplies/ServicesQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyTotal
0001Pre-Employment
0001AAPre-Employment Medical Examination26000Each$ - 026000Each$ - 026000Each$ - 026000Each$ - 04500Each$ - 02250Each$ - 0$ - 0110,750$ - 0
0001ABPre-Employment Physical Fitness Test23000Each$ - 023000Each$ - 023000Each$ - 023000Each$ - 02200Each$ - 01100Each$ - 0$ - 095,300$ - 0
0001ACPre-Employment Drug Test30000Each$ - 030000Each$ - 030000Each$ - 030000Each$ - 03000Each$ - 01500Each$ - 0$ - 0124,500$ - 0
0001ADExpediting Fee upon request of Agency10Each$ - 010Each$ - 010Each$ - 010Each$ - 010Each$ - 05Each$ - 0$ - 055$ - 0
0001AETravel1LO$ 25,000.001LO$ 25,000.001LO$ 25,000.001LO$ 25,000.00$ 25,000.00$ 12,500.00$ 137,500.00
0002Fitness for Duty / Independent Medical Examinations
0002AAGeneral Medical Independent Medical Examination with Report20Each$ - 020Each$ - 020Each$ - 020Each$ - 020Each$ - 010Each$ - 0$ - 0110$ - 0
0002ABSpecialty Consultant Independent Medical Examination (IME) with Report
0002AB1Specialty Consult - Internal Medicine (IME) with Report5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0002AB2Specialty Consult - Cardiology (IME) with Report5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0002AB3Specialty Consult - Orthopedic (IME) with Report5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0002AB4Specialty Consult - Psychiatric (IME) with Report5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0002AB5Specialty Consult - Neurology (IME) with Report5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0002ACCertified Independent Medical Evaluation with Report6Each$ - 06Each$ - 06Each$ - 06Each$ - 06Each$ - 03Each$ - 0$ - 033$ - 0
0002ADForensic Psychiatric Evaluation with Report6Each$ - 06Each$ - 06Each$ - 06Each$ - 030Each$ - 03Each$ - 0$ - 057$ - 0
0002AEIndependent Medical Examination - No Show5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 01$ - 0
0002AFSecondary and Tertiary Reviews (Paper Only) - BILLED AT AN HOURLY RATE450HR$ - 0450HR$ - 0450HR$ - 0450HR$ - 0450HR$ - 0225HR$ - 0$ - 02,475$ - 0
0002AGInternal Medicine (IME) Specialist, Additional Hours - BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002AHCardiology (IME) Specialist, Additional Hours - BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002AIOrthopedic (IME) Specialist, Additional Hours- BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002AJPsychiatric (IME) Specialist, Additional Hours - BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002AKInternal Medicine (IME) Specialist, Additional Hours - BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002ALNeurology (IME) Specialist, Additional Hours - BILLED AT AN HOURLY RATE18HR$ - 018HR$ - 018HR$ - 018HR$ - 018HR$ - 09HR$ - 0$ - 099$ - 0
0002AMMedical Tests (prior approval required)$ - 0$ - 00$ - 00$ - 00$ - 00$ - 0$ - 00$ - 0
0002AM1Medical Test - OSHA Audiometry (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 018Each$ - 00.5Each$ - 0$ - 099$ - 0
0002AM2Medical Tests - Blood glucose (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 020Each$ - 00.5Each$ - 0$ - 025$ - 0
0002AM3Medical Tests - Blood lead level (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 018Each$ - 00.5Each$ - 0$ - 099$ - 0
0002AM4Medical Tests - CBC with differential (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 020Each$ - 00.5Each$ - 0$ - 025$ - 0
0002AM5Medical Tests - Chemistry Profile (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM6Medical Tests - Cardiac risk level (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 018Each$ - 00.5Each$ - 0$ - 099$ - 0
0002AM7Medical Tests - Color vision assessment (HRR Test) (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 020Each$ - 00.5Each$ - 0$ - 025$ - 0
0002AM8Medical Tests - Hemoglobin A1C (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 018Each$ - 00.5Each$ - 0$ - 099$ - 0
0002AM9Medical Tests - Lab profile (CBC with differential, chemistry profile, urinalysis) (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 020Each$ - 00.5Each$ - 0$ - 025$ - 0
0002AM10Medical Tests - Maximal stress EKG with MD interpretation (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM11Medical Tests - Peripheral vision and visual depth perception (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM12Medical Tests - Protoporphyrin, zinc (ZPP) blood test (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM13Medical Tests - Resting twelve lead EKG with MD interpretation (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM14Medical Tests - Spirometry (FVC%, FEV1, FEV1/FVC%) (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM15Medical Tests - Thyroid Panel (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM16Medical Tests - TB Skin test (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM17Medical Tests - Urinalysis (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM18Medical Tests - Visual acuity (corrected and uncorrected, near and distant) (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM19Medical Tests - Psychological/Psychiatric testing (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM20Medical Tests - Resting EKG with physician interpretation (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM21Medical Tests - Chest x-ray (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM22Medical Tests - Functional Capacity Evaluation with Report (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0002AM23Medical Tests - Neuropsychological Testing with Report (prior approval required)1Each$ - 01Each$ - 01Each$ - 01Each$ - 010Each$ - 00.5Each$ - 0$ - 015$ - 0
0003Drug Free Work Place
0003AARandom Drug Test Urinalysis Collection2687Each$ - 02687Each$ - 02687Each$ - 02687Each$ - 02687Each$ - 01343.5Each$ - 0$ - 014,779$ - 0
0003ABPost-Accident Drug Test Urinalysis Collection30Each$ - 030Each$ - 030Each$ - 030Each$ - 030Each$ - 015Each$ - 0$ - 0165$ - 0
0003ACReasonable Suspicion Drug Test Urinalysis Collection30Each$ - 030Each$ - 030Each$ - 030Each$ - 030Each$ - 015Each$ - 0$ - 0165$ - 0
0003ADStatistician for Random Drug Test12Each$ - 012Each$ - 012Each$ - 012Each$ - 012Each$ - 06Each$ - 0$ - 066$ - 0
0003AELitigation Package (Laboratory Documentation for Positive Drug Tests Reports)10Each$ - 010Each$ - 010Each$ - 010Each$ - 010Each$ - 05Each$ - 0$ - 055$ - 0
0004Ancillary Services
0004AAOne Stop Mobile Event with Fitness Testing (3 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 012$ - 0
0004ABOne Stop Mobile Event with Fitness Testing (4 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 03Each$ - 013$ - 0
0004ACOne Stop Mobile Event with Fitness Testing (5 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 03Each$ - 013$ - 0
0004ADOne Stop Mobile Event minus Fitness Testing (3 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 012$ - 0
0004AEOne Stop Mobile Event minus Fitness Testing (4 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 03Each$ - 013$ - 0
0004AFOne Stop Mobile Event minus Fitness Testing (5 day event)2Each$ - 02Each$ - 02Each$ - 02Each$ - 02Each$ - 03Each$ - 013$ - 0
Total CostBase Year$25,000.00Opt 1$ 25,000.00Opt 2$ 25,000.00Opt 3$ 25,000.00Opt 4$ 25,000.00-8 Ext$ 12,500.0066 Month Total$ 137,500.00
$ 137,500.00

Sheet1

OSHA Audiometry
Blood glucose
Blood lead level
CBC with differential
Chemistry Profile
· Cardiac risk level (The Cardiac Risk Profile is a very standard phrase referring to a laboratory determination of serum total cholesterol, triglycerides, LDL, HDL, and a ratio estimating a person risk for developing cardiovascular disease.)
· Color vision assessment (Ishihara 14 plate edition)
· Hemoglobin A1C
· Lab profile (CBC with differential, chemistry profile, urinalysis)
· Maximal stress EKG with MD interpretation
· Peripheral vision and visual depth perception
· Protoporphyrin, zinc (ZPP) blood test
· Resting twelve lead EKG with MD interpretation
· Spirometry (FVC%, FEV1, FEV1/FVC%)
· Thyroid Panel
· TB Skin test (with chest x-ray if indicated)
· Urinalysis
· Visual acuity (corrected and uncorrected, near and distant)
· Psychological/Psychiatric testing
· Resting EKG with physician interpretation
· Chest x-ray with physician interpretation for those with a positive tuberculosis skin test and symptoms suggestive of pulmonary tuberculosis.

File details come from the government source that posted it. Updated .