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Subject Matter Experts –Mental Health
HSHQDC-15-Q-00170
ATTACHMENT A
Contract Line Item Numbers for Supplies or Services and Price/Cost
*Note: DHS intends to acquire these services by awarding two (2) multiple contracts. However, DHS reserves the right to increase or decrease the number of awardees based upon the results of the evaluation. Estimated hours will be among the two awardees equally. The total combined amount of hours will not exceed 200 hours.
Base Year
| CLIN |
| Description |
| Estimated Quantity |
| Unit |
| Unit Price |
| Total |
| 0001 |
| Subject Matter Experts –Mental Health |
| 200 |
| *HR |
| $________ |
| $________ |
$ 8,000.00 (Not-To-exceed)
| Base Year Price |
| $________ |
Option Year One
| CLIN |
| Description |
| Estimated Quantity |
| Unit |
| Unit Price |
| Total |
| 1001 |
| Subject Matter Experts –Mental Health |
| 200 |
| *HR |
| $________ |
| $________ |
$ 8,000.00 (Not-To-exceed)
| Option Year One Price |
| $________ |
Option Year Two
| CLIN |
| Description |
| Estimated Quantity |
| Unit |
| Unit Price |
| Total |
| 2001 |
| Subject Matter Experts –Mental Health |
| 200 |
| *HR |
| $________ |
| $________ |
$ 8,000.00 (Not-To-exceed)
| Option Year Two Price |
| $________ |
Option Year Three
| CLIN |
| Description |
| Estimated Quantity |
| Unit |
| Unit Price |
| Total |
| 3001 |
| Subject Matter Experts –Mental Health |
| 200 |
| *HR |
| $________ |
| $________ |
$ 8,000.00 (Not-To-exceed)
| Option Year Three Price |
| $________ |
Option Year Four
| CLIN |
| Description |
| Estimated Quantity |
| Unit |
| Unit Price |
| Total |
| 4001 |
| Subject Matter Experts –Mental Health |
| 200 |
| *HR |
| $________ |
| $________ |
$ 8,000.00 (Not-To-exceed)
| Option Year Four Price |
| $________ |
