Attachment 4 - Price Schedule_Rev.xlsx

XLSX spreadsheet 52 KB Posted Dec 19, 2025

Attached to: Amended - FYSU Fixed Removable Dental Laboratory Services
Solicitation number: IHS1519511
Issued by: Department of Health and Human Services Indian Health Service

About this file

Written by GovTribe AI · Dec 19, 2025

The file is a Price Schedule Excel template for a dental laboratory services contract with the Fort Yuma Health Center (FYHC) through the Indian Health Service. The detailed pricing document covers a base period and four option years, categorizing dental laboratory services into three main areas: Replacement (fabrication of new prosthetic devices), Restoration (fabrication to restore existing tooth or prosthesis), and Removal (laboratory work associated with removal/modification). The template allows for pricing of specific dental services including fixed prosthetic replacements, complete and partial dentures, crown replacements, and prosthesis modifications.

The pricing template includes comprehensive cost breakdown sections for line items, fringe benefits, overhead, other direct costs (ODCs), and various additional cost categories such as travel, subcontracts, consultants, and materials. The document provides placeholder columns for quantities, unit prices, and total prices across different contract periods, with placeholder assumptions for inflation rates, fringe benefits, overhead, and G&A rates. While no specific pricing is populated in the template, it is designed to support a flexible pricing approach for dental laboratory services, allowing vendors to customize their submissions within the provided framework.

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Attachment 4 - Price Schedule_ver2.xlsx	XLSX spreadsheet	Jan 12, 2026
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Attachment 6 - 2025 Hospital - Phoenix Area Indian Health Service.pdf	PDF	Dec 18, 2025
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Attachment 4 - Price Schedule.xlsx	XLSX spreadsheet	Dec 18, 2025
Attachment 1 - Synopsis.pdf	PDF	Dec 18, 2025

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IGCE

Price Schedule
PROJECT TITLE: Dental Laboratory
Detailed Price Summary
Note: This template can be modified based on the contract type (i.e. Firm Fixed Price, Time and Materials, and Cost Reimburesment)
Contract Line Item Description	Base Period				Option Year One				Option Year Two				Option Year Three				Option Year Four
	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price
FYSU FY25 Department Name:Dental	0.00		$ - 0	$ - 0	0.00		$ - 0	$ - 0	0.00	EA	$ - 0	$ - 0	0.00	EA	$ - 0	$ - 0	0.00	EA	$ - 0	$ - 0
I. REPLACEMENT (Fabrication of New Prosthetic Devices)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Fixed Prosthetic Replacement (e.g., crown, bridge unit, implant abutment)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Removable Prosthetic Replacement – Complete Denture (per arch)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Removable Prosthetic Replacement – Partial Denture (any type)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
II. RESTORATION (Fabrication to Restore Existing Tooth or Prosthesis)	0.00		$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Fixed Prosthetic Restoration (e.g., veneer, crown replacement for damaged tooth)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Restoration of Existing Removable Prosthesis (e.g., tooth addition, authorized reline)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
III. REMOVAL (Laboratory Work Associated With Removal/Modification)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0				$ - 0				$ - 0				$ - 0
Tooth/Prosthesis Removal (e.g., stay plate)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0				$ - 0				$ - 0				$ - 0
Laboratory Modification Due to Removal (authorized adjustment or modification only)	0.00	EA	$ - 0	$ - 0	0.00		$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0			$ - 0	$ - 0
Line Item Subtotal				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Fringe Benefits				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Subtotal Line Item & Fringe				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Overhead				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Subtotal Line Items, Fringe and Overhead				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
ODC's
Travel				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Subcontracts				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Consultants				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Materials				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
CDs				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Subtotal ODCs				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Subtotal - All Costs				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
G&A				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Total Cost				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Fee/Profit				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
Total Estimated Yearly Values				$ - 0				$ - 0				$ - 0				$ - 0				$ - 0
TOTAL ESTIMATED VALUE OF CONTRACT	$ - 0

Assumptions:	Percent
Inflation Rate Per Year	0.00%
Fringe Benefits Rate	0.00%
Overhead Rate	0.00%
G&A Rate	0.00%
Fee/Profit Percentage	0.00%

&F&D&T

File details come from the government source that posted it. Updated Dec 19, 2025.