Laboratory Testing IFB Financial Proposal Form Draft (2025-2030) (1) (1) (1).xlsx
XLSX spreadsheet 42 KB Posted
- Attached to
- (REBID) 26-MULTI-FS-MS-007 Laboratory Services
- Solicitation number
- BPM057836
- Issued by
- Maryland
About this file
This is a Financial Proposal Form and Bid Instructions document for a rebid of Laboratory Services by the State of Maryland Department of Juvenile Services (DJS). The solicitation seeks medical laboratory testing services for youth housed at six DJS facilities. The bid form itemizes 57 laboratory tests spanning somatic health services, including comprehensive drug monitoring, infectious disease panels, metabolic panels, and specialized diagnostic tests. Estimated annual service units range from 5 tests (Treponema Pallidum Antibody) to 1,500 tests (CBC with differential). The contract term spans five years (Years 1-5), with pricing submission required for each year. Bidders must provide unit prices for all listed tests and include laboratory turnaround time (TAT) in days. All pricing must be fully loaded to include labor, overhead, administrative costs, and all expenses necessary to perform required services.
Bidders are required to submit pricing on the provided bid form without alterations, with all unit and extended prices clearly entered in dollars and cents rounded to the nearest cent. All blank fields must be completed, and any changes or corrections must be initialed and dated. The total bid price represents the sum of all annual costs across the five-year contract period. Sample amounts used for calculations are estimates only, and the Department does not guarantee minimum or maximum usage levels. The authorized signatory must sign and date the bid form and provide company information including FEIN and eMMA number. Failure to adhere to bid instructions may result in the bid being deemed non-responsive and rejected.
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Instructions
| FINANCIAL PROPOSAL FORM |
| ATTACHMENT B - BID FORM INSTRUCTIONS |
Solicitation No:___
In order to assist Offeror in the preparation of their Bid and to comply with the requirements of this solicitation, Bid Pricing Instructions and a Bid Form have been prepared. Offerors shall submit their Bid on the Bid Form in accordance with the instructions on the Bid Form and as specified herein. Do not alter the Bid Form or the Bid Form may be rejected. The Bid Form is to be signed and dated, where requested, by an individual who is authorized to bind the Bidder to the prices entered on the Bid Form.
The Bid Form is used to calculate the Offeror's TOTAL BID PRICE. Follow these instructions carefully when completing your Bid Form:
A) All Unit and Extended Prices must be clearly entered in dollars and cents, e.g., $24.15. Make your decimal points clear and distinct
B) All Unit Prices must be the actual price per unit the State will pay for the specific item or service identified in this RFP and may not be contingent on any other factor or condition in any manner.
C) All calculations shall be rounded to the nearest cent, i.e., .344 shall be .34 and .345 shall be .35.
D) Any goods or services required through this RFP and proposed by the vendor at No Cost to the State must be clearly entered in the Unit Price, If appropriate, and Extended Price with $0.00.
E) Every blank in every Bid Form shall be filled in. Any blanks may result in the Bid being regarded as non-responsive and thus rejected. Any changes or corrections made to the Bid Form by the Offeror prior to submission shall be initialed and dated.
F) Except as instructed on the Bid Form, nothing shall be entered on or attached to the Bid Form that alters or proposes conditions or contingencies on the prices. Alterations and/or conditions usually render the Bid non-responsive, which means it will be rejected.
G) It is imperative that the prices included on the Bid Form have been entered correctly and calculated accurately by the Bidder and that the respective total pricing agree with the entries on the Bid Form. Any incorrect entries or inaccurate calculations by the Offeror will be treated as provided in COMAR 21.05.03.03E and 21.05.02.12, and may cause the Bid to be rejected.
H) If option years are included, Offeror must submit pricing for each option year. Any options to renew will be exercised at the sole discretion of the State and will comply with all terms and conditions in force at the time the option is exercised. If exercised, the option period shall be for a period identified in the IFB at the prices entered in the Bid Form.
I) All Bid prices entered below are to be fully loaded prices that include all costs/expenses associated with the provision of services as required by the RFP. The Bid price shall include, but is not limited to, all: labor, profit/overhead, general operating, administrative, and all other expenses and cost necessary to perform the work set forth in the solicitation. No other amounts will be paid to the Contractor. If labor rates are requested, those amounts shall be fully-loaded rates; no overtime amounts will be paid.
J) Unless indicated elsewhere in the RFP, sample amounts used for calculations on the Bid Form are typically estimates for bidding purposes only. The Department does not guarantee a minimum or maximum number of units or usage in the performance of this Contract.
K) Failure to adhere to any of these instructions may result in the Bid being deteremined non-responsive and rejected by the Department.
Bid Sheet
| ATTACHMENT B - BID FORM | ||
| Solicitation No: | ||
| STATE OF MARYLAND | ||
| DEPARTMENT OF JUVENILE SERVICES | ||
| LABORATORY SERVICE AT DJS FACILITIES |
DJS Somatic Health
Bidders Name:
| Services | CPT Code | Vendors Test Code | Estimated Units of Service per Year | Lab Turnaround Time (TAT) # of days | Unit Price | Year 2 | Year 3 | Year 4 | Total Annual Cost | |
| Testing Services-Itemized | ||||||||||
| Amylase Serum | 82150 | 10 | ||||||||
| Antinuclear Antibody (ANA) IFA | 86038 | 20 | $0.00 | Vendor to fill out only yellow fields. All other fields need to be locked to protect formulas. | ||||||
| Basic Metabolic Profile (BMP) | 80048 | 50 | $0.00 | |||||||
| C-Reactive Protein (CRP) Serum | 86140 | 20 | $0.00 | |||||||
| CBC, w/diff, Platelet Ct | 85025 | 1500 | $0.00 | |||||||
| Cholesterol | 82465 | 200 | $0.00 | |||||||
| Comprehensive Drug Monitoring (to test for Amphetamines, Barbiturates, Benzodiazepines, Buprenorphrine, Cocaine Metabolite, Ethyl Glucuronide, Fentanyl, Heroin Metabolite, Marijuana Metabolite, Methadone, Methamphetamine, Methylenedioxymethamphetamine (MDMA), Morphine, Opiates, Oxycodone, Phencyclidine, Synthetic Cannabinoids, Tramadol) | 100 | $0.00 | ||||||||
| Comprehensive Metabolic Panel | 80053 | 350 | $0.00 | |||||||
| Cystatin C with eGFR | 82610 | 10 | $0.00 | |||||||
| Diabetes Autoimmune Panel (GADA IAA, IA- 2A, ZnT8A) | 13621 | 50 | ||||||||
| EBV Panel (CAPSID/EBNA G&M) | 86663, 86664, 86665x2 | 10 | $0.00 | |||||||
| Ferritin | 82728 | 40 | $0.00 | |||||||
| Glucose, plasma | 82947 | 20 | $0.00 | |||||||
| HCG, Quantitative, Serum | 84702 | 25 | $0.00 | |||||||
| Hemoglobin A1c (Glycohgb) | 83036 | 200 | $0.00 | |||||||
| Hemoglobinopathy Evaluation (testing for Hemoglobin A, F, A2, S, C, E and any Hemoglobin variants) | 83020, 85014, 85018, 85041 | 10 | $0.00 | |||||||
| HEP B Surf Antigen | 87340 | 30 | $0.00 | |||||||
| Hepatic Function Panel | 80076 | 30 | $0.00 | |||||||
| Hepatitis C RNA, Quant, PCR | 87522 | 50 | $0.00 | |||||||
| HIV AG/AB 4th Generation | 87389 | 850 | $0.00 | |||||||
| Influenza A and B RNA, Qual Real Time PCR | 87502 | 100 | $0.00 | |||||||
| Iron & TIBC | 83540, 83550 | 20 | $0.00 | |||||||
| Islet Cell AB Screen | 36741 | 50 | $0.00 | |||||||
| Lead, Blood | 83655 | 40 | $0.00 | |||||||
| Lipase Serum | 83690 | 10 | $0.00 | |||||||
| Lipid Screen (Basic Lipid Profile) (Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation) | 80061 | 700 | $0.00 | |||||||
| Lithium, serum | 80178 | 20 | $0.00 | |||||||
| Prenatal Panel (CBC, Antibody Screen RBC w/Reflex, ABO-RH, RPR w/Reflex, HBsAg w/Reflex, Rubella, IgG) | 80055 | 12 | $0.00 | |||||||
| Prolactin, serum | 84146 | 40 | $0.00 | |||||||
| Prothrombin Time/INR (PT) | 85610 | 20 | $0.00 | |||||||
| PTT (Partial Thromboplastin Time) | 85730 | 20 | $0.00 | |||||||
| QuantiFERON-TB Gold Plus | 86480 | 20 | $0.00 | |||||||
| RPR test | 86592 | 800 | $0.00 | |||||||
| RPR w/Reflex to Titer | 86593 | 25 | $0.00 | |||||||
| SARS-Cov-2 RNA (Covid 19) Qualitative | 87635 | 250 | $0.00 | |||||||
| Sed Rate by Mod West | 85652 | 40 | $0.00 | |||||||
| T. Vaginalis RNA | 87661 | 20 | $0.00 | |||||||
| T4, Free (FT4) | 84439 | 100 | $0.00 | |||||||
| Testosterone, free & total, serum | 82040, 84270, 84403 | 15 | $0.00 | |||||||
| Throat Culture, Routine | 87070 | 100 | $0.00 | |||||||
| Treponema Pallidum Antibody Immunoassay | 86780 | 5 | $0.00 | |||||||
| TSH (Thyroid Stimulating Hormone) | 84443 | 150 | $0.00 | |||||||
| Urinalysis, Complete with Micro Color; appearance; specific gravity; pH; protein; glucose; occult blood; ketones; leukocyte esterase; nitrite; bilirubin; urobilinogen, WBC, RBC, Squamous Epithelial Cells Transitional Epithelial, Renal Epithelial Cells, Bacteria, Calcium Oxalate Crystals, Triple Phosphate Crystals, Uric Acid Crystals, Amorphous Sediment, Crystals | 81001 | 100 | $0.00 | |||||||
| Urine Buprenorphine Quantitative | 80348, 80362 | 50 | $0.00 | |||||||
| Urine Culture, routine (negative result) | 87086 | 150 | $0.00 | |||||||
| Urine Culture, routine (with a positive E coli result, with susceptability testing) | 150 | $0.00 | ||||||||
| Vaginitis Panel (DNA probe for Candida, Trichomonas, Gardnerella Species) | 87480, 87510, 87660 | 50 | $0.00 | |||||||
| Vitamin D, 25-Hydroxy, Serum | 82306 | 200 | $0.00 | |||||||
| Total Price per Year | ERROR:#REF! | ERROR:#REF! | ERROR:#REF! | $0.00 |
Total Bid Price - (Sum of Years 1-5) $0.00
Authorized Signature Date
Printed Name and Title FEIN
| Bidder's Name | eMMA# | |
| 16 | ||
| 17 | ||
| 18 | Bidder's Address | |
| 19 |
Contact Information of Above Authorized Signatory: Email Address & Telephone #
| 22 |
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| 28 |
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File details come from the government source that posted it. Updated .