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Price Breakdown Worksheet
| Price Breakdown Worksheet, SOLICITATION NUMBER: W912J2-21-R-0016 Employee Assistance Program |
| Company Name: |
| Base Year (8/31/21 - 8/30/22) | Quantity | Cost Per Unit | Total |
| Line Item 0001: Employee Assistance Program (120 Employees Max) | 120 | | $ - 0 |
| Line Item 0002: EAP Supervisor Training (4 Hours Per Year Max) | 4 | | $ - 0 |
| Line Item 0003: Climate Assessment Surveys (100 Hours Per Year Max) | 100 | | $ - 0 |
| Option Year 1 (8/31/22 - 8/30/23) | Quantity | Cost Per Unit | Total |
| Line Item 1001: Employee Assistance Program (120 Employees Max) | 120 | | $ - 0 |
| Line Item 1002: EAP Supervisor Training (4 Hours Per Year Max) | 4 | | $ - 0 |
| Line Item 1003: Climate Assessment Surveys (100 Hours Per Year Max) | 100 | | $ - 0 |
| Option Year 2 (8/31/23 - 8/30/24) | Quantity | Cost Per Unit | Total |
| Line Item 2001: Employee Assistance Program (120 Employees Max) | 120 | | $ - 0 |
| Line Item 2002: EAP Supervisor Training (4 Hours Per Year Max) | 4 | | $ - 0 |
| Line Item 2003: Climate Assessment Surveys (100 Hours Per Year Max) | 100 | | $ - 0 |
| Option Year 3 (8/31/24 - 8/30/25) | Quantity | Cost Per Unit | Total |
| Line Item 3001: Employee Assistance Program (120 Employees Max) | 120 | | $ - 0 |
| Line Item 3002: EAP Supervisor Training (4 Hours Per Year Max) | 4 | | $ - 0 |
| Line Item 3003: Climate Assessment Surveys (100 Hours Per Year Max) | 100 | | $ - 0 |
| Option Year 4 (8/31/25 - 8/30/26) | Quantity | Cost Per Unit | Total |
| Line Item 4001: Employee Assistance Program (120 Employees Max) | 120 | | $ - 0 |
| Line Item 4002: EAP Supervisor Training (4 Hours Per Year Max) | 4 | | $ - 0 |
| Line Item 4003: Climate Assessment Surveys (100 Hours Per Year Max) | 100 | | $ - 0 |
TOTAL Contract Price - Base Plus Four Options: $ - 0
