POST -OCMP-26-25154 -ATTACHMENT B-1 -BID FORM Licensed Psychologist for Potomac Center and SETT.xlsx
XLSX spreadsheet 109 KB Posted
- Solicitation number
- BPM057608
- Issued by
- Washington County, Maryland
About this file
This is a Financial Bid Form for an Invitation for Bids (IFB) issued by the Maryland Department of Health (MDH) to procure services for the Potomac Center and Secure Evaluation & Therapeutic Treatment (SETT) facility. The solicitation seeks a staffing firm to source one Licensed Psychologist to provide part-time psychology services on-site at the Potomac Center/SETT campus in Hagerstown, Maryland. The position is responsible for providing care, custody, and guidance for individuals with Intellectual Disabilities who may have co-existing mental disorders and forensic involvement. The contract includes two base years with specific service requirements: Base Year One requires 32 hours of mandatory on-site training and 1,040 hours of Licensed Psychologist services (Part-time) for a total of 1,072 annual hours; Base Year Two requires 16 hours of mandatory recertification training and 1,040 hours of Licensed Psychologist services for a total of 1,056 annual hours. All services must comply with ICF/ID standards established by the Office of Health Care Quality, MDH, and all applicable Maryland and federal laws and regulations governing Psychologists.
Bidders must submit pricing on the provided Bid Form with all Unit and Extended Prices clearly entered in dollars and cents as fully loaded rates that include all labor, profit, overhead, general operating, administrative, and other expenses necessary to perform the work. Every blank on the Bid Form must be completed, and any corrections must be initialed and dated by the bidder. The form requires separate pricing entries for each service type and hour category in both base years, with automatic calculation of the total proposal price for the two base years. The Potomac Center will only pay for hours actually worked, and MDH does not guarantee a minimum or maximum number of units or usage under the contract. Bidders must sign and date the form certifying that both technical and price submissions are correct and that they agree to perform all services stated in the IFB solicitation.
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Instructions B-1 Bid Instructions
| In order to assist each Bidder in the preparation of its Bid and to comply with the requirements of this solicitation, Bid Instructions and a Bid Form have been prepared. Each Bidder shall submit its 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 may be determined to be not responsive. 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 Bidder’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 IFB and may not be contingent on any other factor or condition in any manner.
C) All calculations shall be rounded to the nearest cent, e.g., .344 shall be .34 and .345 shall be .35.
D) Any goods or services required through this IFB 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 changes or corrections made to the Bid Form by the Bidder 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 may render the Bid not responsive.
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 prices agree with the entries on the Bid Form. Any incorrect entries or inaccurate calculations by the Bidder will be treated as provided in COMAR 21.05.02.12 and may cause the Bid to be rejected.
H) If option years are included, Bidders must submit pricing for each option year. Any option to renew will be exercised at the sole discretion of the State and 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 IFB. The Bid price shall include, but is not limited to, all: labor, profit/overhead, general operating, administrative, and all other expenses and costs 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 IFB, sample amounts used for calculations on the Bid Form are typically estimates for evaluation purposes only. Unless stated otherwise in the IFB, the Department does not guarantee a minimum or maximum number of units or usage in the performance of the Contract.
K) Failure to adhere to any of these instructions may result in the Bid being determined not responsive
The Potomac Center will only pay for hours actually worked.
Summary
| ATTACHMENT B -1 Financial Bid Form |
| Solicitation No. OCMP-26-25154 |
| Licensed Psychologist for MDH Potomac Center and Secure Evaluation & Therapeutic Treatment (SETT) |
| The summary below outlines tabulations from each year provided by the Offeror and automatically calculated. | |
| Offeror Price Base Year 1 | $ - 0 |
| Offeror Price Base Year 2 | $ - 0 |
| TOTAL PROPOSAL PRICE FOR TWO BASE YEARS | $ - 0 |
| Submitted By: |
| Authorized Signature: _______________________________________________________ |
| Date: ________________________ |
| Printed Name and Title: _____________________________________________________ | |
| Offeror Name: ____________________________________________________________ | |
| Offeror Address: ___________________________________________________________ | |
| Location(s) from which services will be performed (City/State): | |
| ________________________________________________________________________ | |
| FEIN: ____________________________________________ | eMMA # _________________________________ |
MARYLAND DEPARTMENT OF HEALTH (MDH) DOES NOT GUARENTEE A MINIMUM OR MAXIMUM UNDER THIS CONTRACT.
*NOTE: All Financial Proposal prices entered above are to be fully loaded prices that include all costs/expenses associated with the provision of services as required by the RFP. The Financial Proposal price shall include, but is not limited to, all: labor, profit/overhead, general operating, administrative, and all other expenses and costs 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.
Attachment B-1 FINANCIAL FORM
| ATTACHMENT B-1 FINANCIAL BID FORM | |
| Licensed Psychologist for MDH Potomac Center and Secure Evaluation & Therapeutic Treatment (SETT) | |
| OCMP-26-25154 |
Period from _____________ to _________________
| BASE YEAR ONE | |||
| Type of Service Hours | # Hours | Rate Per Hour | Cost |
| Mandatory Training (provided on-site) | 32 | $ - 0 | |
| Licensed Psychologist Services (Part-time) | 1,040 | $ - 0 | |
| Total Annual Hours | 1,072 | ||
| Total Cost: Base Year One (1) | $ - 0 |
| BASE YEAR TWO | |||
| Type of Service Hours | # Hours | Rate Per Hour | Cost |
| Mandatory Training Recertification (provided on-site) | 16 | $ - 0 | |
| Licensed Psychologist Services (Part-time) | 1,040 | $ - 0 | |
| Total Annual Hours | 1,056 | ||
| Total Cost: Base Year Two (2) | $ - 0 |
| TOTAL BID PRICE SUBMISSION | |
| TOTAL COST BASE YEAR ONE | $ - 0 |
| TOTAL COST BASE YEAR TWO | $ - 0 |
| TOTAL FOR TWO BASE YEARS | $ - 0 |
MARYLAND DEPARTMENT OF HEALTH (MDH) DOES NOT GUARENTEE A MINIMUM OR MAXIMUM UNDER THIS CONTRACT.
Submitted by:
| Signature of Authorized Representative | |
| Printed Name and Title: | 1 |
| Telephone: | |
| Email address: | |
| Bidder Company Name: | |
| Bidder Company Address: | |
| Location(s) from which goods/services will be provided/performed (City/State): |
| FEIN: |
| eMMA #: |
Vendor signature and date certifies that technical and price submissions are correct and that vendor agrees to perform all services stated in the IFB Solicitation.
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