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Instructions Teleradiology Services N62645-19-Q-0016
| Instructions to Offerors: | |
| 1 | The Pricing Workbook includes proposed unit prices for each type of study and all initial requirements (A, B, and C) that will be issued as task orders after contract award. The proposed unit prices for each type of study will be incoporated in the base contract. |
| 2 | The offeror shall fill out the Proposed Prices Per Study Tab for CONUS and OCONUS locations. Blue boxes designate those fields into which the offeror can enter values/information. The offeror shall only enter values/information in the blue boxes. |
| 3 | The Tabs calculate the total proposed price for the base and option years based on the unit price proposed in the Prices Per Study Tab. The offeror shall not fill out these tabs. |
| 4 | The Summary Tab calculates the grand total price for all intitial requirements. The offeror shall not fill out this tab. |
| 5 | Billing will occur on a monthly basis based on the actual number of studies performed. |
Prices Per Study
| Proposed Unit Price for CONUS MTFs | | | | |
| Base Year | Option Year 1 | Option Year 2 | Option Year 3 | Option Year 4 |
| Type of Study | 01 DEC 19 - 30 NOV 20 | 01 DEC 20 - 30 NOV 21 | 01 DEC 21 - 30 NOV 22 | 01 DEC 22 - 30 NOV 23 | 01 DEC 23 - 30 NOV 24 |
| Computed Tomography | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Proposed Unit Price for OCONUS MTFs | | | | |
| Base Year | Option Year 1 | Option Year 2 | Option Year 3 | Option Year 4 |
| Type of Study | 01 DEC 19 - 30 NOV 20 | 01 DEC 20 - 30 NOV 21 | 01 DEC 21 - 30 NOV 22 | 01 DEC 22 - 30 NOV 23 | 01 DEC 23 - 30 NOV 24 |
| Computed Tomography | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Requirement A
| Requirement A | | | | | | | | | | | |
| Naval Hospital Jacksonville (SLINS 0001AA, 1001AA, 2001AA, 3001AA, and 4001AA) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001AA | | SLIN 1001AA | | SLIN 2001AA | | SLIN 3001AA | | SLIN 4001AA | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 2922 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 1117 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 44 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 1872 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 7 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
Total Proposed Price for SLINS 0001AA, 1001AA, 2001AA, 3001AA, and 4001AA: $ - 0
| Naval Hospital Pensacola (SLINS 0001AB, 1001AB, 2001AB, 3001AB, and 4001AB) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001AB | | SLIN 1001AB | | SLIN 2001AB | | SLIN 3001AB | | SLIN 4001AB | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 1000 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 200 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 1000 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 1000 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 5 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
Total Proposed Price for SLINS 0001AB, 1001AB, 2001AB, 3001AB, and 4001AB: $ - 0
| Naval Medical Center Camp Lejeune (SLINS 0001AC, 1001AC, 2001AC, 3001AC, and 4001AC) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001AC | | SLIN 1001AC | | SLIN 2001AC | | SLIN 3001AC | | SLIN 4001AC | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 2500 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 1000 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 500 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 100 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 10 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
Total Proposed Price for SLINS 0001AC, 1001AC, 2001AC, 3001AC, and 4001AC: $ - 0
| Naval Medical Health Clinic Charleston (SLINS 0001AD, 1001AD, 2001AD, 3001AD, and 4001AD) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001AD | | SLIN 1001AD | | SLIN 2001AD | | SLIN 3001AD | | SLIN 4001AD | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 104 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 104 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 200 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 780 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Total Price Per CLIN: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
Total Proposed Price for SLINS 0001AD, 1001AD, 2001AD, 3001AD, and 4001AD: $ - 0
| Naval Health Clinic Corpus Christi (SLINS 0001AE, 1001AE, 2001AE, 3001AE, and 4001AE) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001AE | | SLIN 1001AE | | SLIN 2001AE | | SLIN 3001AE | | SLIN 4001AE | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 160 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 800 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Total Price Per CLIN: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001AE, 1001AE, 2001AE, 3001AE, and 4001AE: | $ - 0 |
| Total Proposed Price for Lot A: | $ - 0 |
Requirement B
| Requirement B | | | | | | | | | | | |
| Naval Health Clinic Lemoore (SLINS 0001BA, 1001BA, 2001BA, 3001BA, and 4001BA) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001BA | | SLIN 1001BA | | SLIN 2001BA | | SLIN 3001BA | | SLIN 4001BA | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 150 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 150 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 1200 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 40 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001BA, 1001BA, 2001BA, 3001BA, and 4001BA: | | $ - 0 | | | | | | | | | |
| Naval Hospital Bremerton (SLINS 0001BB, 1001BB, 2001BB, 3001BB, and 4001BB) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001BB | | SLIN 1001BB | | SLIN 2001BB | | SLIN 3001BB | | SLIN 4001BB | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 1620 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 353 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 36 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 60 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 12 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001BA, 1001BB, 2001BB, 3001BB, and 4001BB: | | $ - 0 | | | | | | | | | |
| Naval Hospital Camp Pendleton (SLINS 0001BC, 1001BC, 2001BC, 3001BC, and 4001BC) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001BC | | SLIN 1001BC | | SLIN 2001BC | | SLIN 3001BC | | SLIN 4001BC | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 3354 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 1122 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 55 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 10 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001BC, 1001BC, 2001BC, 3001BC, and 4001BC: | | $ - 0 | | | | | | | | | |
| Naval Hospital Twentynine Palms (SLINS 0001BD, 1001BD, 2001BD, 3001BD, and 4001BD) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001BD | | SLIN 1001BD | | SLIN 2001BD | | SLIN 3001BD | | SLIN 4001BD | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | 1242 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | 894 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | 2500 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | 545 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001BD, 1001BD, 2001BD, 3001BD, and 4001BD: | $ - 0 |
| Total Proposed Price for Lot B: | $ - 0 |
Requirement C
| Requirement C | | | | | | | | | | | |
| U.S. Naval Hospital Rota (SLINS 0001CA, 1001CA, 2001CA, 3001CA, and 4001CA) | | | | | | | | | | | |
| Type of Study | Number of Studies Per Year | SLIN 0001CA | | SLIN 1001CA | | SLIN 2001CA | | SLIN 3001CA | | SLIN 4001CA | |
| | 01 DEC 19 - 30 NOV 20 | | 01 DEC 20 - 30 NOV 21 | | 01 DEC 21 - 30 NOV 22 | | 01 DEC 22 - 30 NOV 23 | | 01 DEC 23 - 30 NOV 24 | |
| | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price | Unit Price | Total Price |
| Computed Tomography | | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Ultrasound | | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Plain Film | | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Magnetic Resonance Imaging | | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Nuclear Medicine | | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Totals: | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 |
| Total Proposed Price for SLINS 0001CA, 1001CA, 2001CA, 3001CA, and 4001CA: | $ - 0 |
| Total Proposed Price for Lot C: | $ - 0 |
Summary
| Total Proposed Prices | |
| Requirement A | $ - 0 |
| Requirement B | $ - 0 |
| Requirement C | $ - 0 |
| Grand Total Price for Intitial Requirements : | $ - 0 |