Schedule_FBO_R1.xlsx

XLSX spreadsheet 24 KB Posted

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Medical, Psychological, Fitness, and Drug Testing Services
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HSCEMD-17-R-00001
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Draft Pricing Sheet

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Schedule

Estimated Period of PerformanceBase Year7/1/176/30/18Opt 17/1/186/30/19Opt 27/1/196/30/20Opt 37/1/206/30/21Opt 47/1/216/30/22-8 Ext7/1/221/1/2366 Month Total
Item No.Supplies/ServicesQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyUnitRateTotalQtyTotal
0001Pre-Employment
0001APre-Employment Medical Examination4500Each$ - 04500Each$ - 04500Each$ - 04500Each$ - 04500Each$ - 02250Each$ - 0$ - 024,750$ - 0
0001BPre-Employment Physical Fitness Test2200Each$ - 02200Each$ - 02200Each$ - 02200Each$ - 02200Each$ - 01100Each$ - 0$ - 012,100$ - 0
0001CPre-Employment Drug Test Urinalysis Collection3000Each$ - 03000Each$ - 03000Each$ - 03000Each$ - 03000Each$ - 01500Each$ - 0$ - 016,500$ - 0
0001DExpediting Fee upon request of Agency10Each$ - 010Each$ - 010Each$ - 010Each$ - 010Each$ - 05Each$ - 0$ - 055$ - 0
0002Fitness for Duty / Independent Medical Examinations
0002AGeneral Medical Independent Medical Examiniation with Report20Each$ - 020Each$ - 020Each$ - 020Each$ - 020Each$ - 010Each$ - 0$ - 0110$ - 0
0002BSpecialty Consultant Independent Medical Examination with Report90HR$ - 090HR$ - 090HR$ - 090HR$ - 090HR$ - 045HR$ - 0$ - 0495$ - 0
0002CCertified Independent Medical Evaluation with Report60HR$ - 060HR$ - 060HR$ - 060HR$ - 060HR$ - 030HR$ - 0$ - 0330$ - 0
0002DForensic Psychiatric Evaluation with Report30HR$ - 030HR$ - 030HR$ - 030HR$ - 030HR$ - 015HR$ - 0$ - 0165$ - 0
0002EAncillary Medical Tests - Functional Capacity Evaluation with Report20LO$ - 020LO$ - 020LO$ - 020LO$ - 020LO$ - 010LO$ - 0$ - 0110$ - 0
0002FAncillary Medical Tests - Neuropsychological Testing with Report10LO$ - 010LO$ - 010LO$ - 010LO$ - 010LO$ - 05LO$ - 0$ - 055$ - 0
0002GAncillary Medical Tests - Exercise Stress Test with Report10LO$ - 010LO$ - 010LO$ - 010LO$ - 010LO$ - 05LO$ - 0$ - 055$ - 0
0002HTertiaty Reviews (Paper Only)1200HR$ - 01200HR$ - 01200HR$ - 01200HR$ - 01200HR$ - 0600HR$ - 0$ - 06,600$ - 0
0002IIndependent Medical Examination - No Show Fees (Cost Reimburseable)1LO$ 1,000.00$ 1,000.001LO$ 1,000.00$ 1,000.01LO$ 1,000.00$ 1,000.001LO$ 1,000.00$ 1,000.001LO$ 1,000.00$ 1,000.001LO$ 500.00$ 500.00$ 5,500.00
0003Drug Free Work Place
0003ARandom Drug Test Urinalysis Collection2000Each$ - 02000Each$ - 02000Each$ - 02000Each$ - 02000Each$ - 01000Each$ - 0$ - 011,000$ - 0
0003BPost-Accident Drug Test Urinalysis Collection15Each$ - 015Each$ - 015Each$ - 015Each$ - 015Each$ - 07.5Each$ - 0$ - 083$ - 0
0003CReasonable Suspicion Drug Test Urinalysis Collection15Each$ - 015Each$ - 015Each$ - 015Each$ - 015Each$ - 07.5Each$ - 0$ - 083$ - 0
0003DExpediting Fee upon request of Agency25Each$ - 025Each$ - 025Each$ - 025Each$ - 025Each$ - 012.5Each$ - 0$ - 0138$ - 0
0003EStatistician for Random Drug Test12Each$ - 012Each$ - 012Each$ - 012Each$ - 012Each$ - 06Each$ - 0$ - 066$ - 0
0003FLitigation Package (Laboratory Documentation for Positive Drug Tests Reports)5Each$ - 05Each$ - 05Each$ - 05Each$ - 05Each$ - 02.5Each$ - 0$ - 028$ - 0
0004Ancillary Services
0004AOne Stop Mobile Event1LO$ 500,000.0$ 500,000.01LO$ 500,000.00$ 500,000.001LO$ 500,000.00$ 500,000.001LO$ 500,000.00$ 500,000.001LO$ 500,000.00$ 500,000.001LO$ 250,000.00$ 250,000.00$ 2,750,000.00
Total CostBase Year$501,000.00Opt 1$ 501,000.00Opt 2$ 501,000.00Opt 3$ 501,000.00Opt 4$ 501,000-8 Ext$ 250,500.0066 Month Total$ 2,755,500.00
$ 2,755,500.00

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