Pricing Sheet RFI.docx

1. FIRM FIXED PRICE (FFP) GROUP MEMBERSHIP

1.a Pre-Paid Group Membership Price***

1.b OPTIONAL*: Pre-Paid Group Membership Price Increase for Medevac Using Portable Medical Isolation Unit (e.g. infectious disease medevac)**

* The Government may require a medevac using a Portable Medical Isolation Unit (e.g. infectious disease medevac). The exercise of the optional coverage will unilaterally be determined by the Government, and shall result in a modification to the contract to update clause 1. CONTRACT VALUE AND CONTRACT FUNDING.

**Prices in Table 1.b represent the delta price from the standard air ambulance coverage, priced in Table 1.a, to provide a medevac using a Portable Medical Isolation Unit (e.g. infectious disease medevac). The sum of the prices identified in 1.a and 1.b represent the total price for the period for medevac coverage that includes using Portable Medical Isolation Unit (e.g. infectious disease medevac). If medevac using a Portable Medical Isolation Unit (e.g. infectious disease medevac) is included in the base membership price in Table 1.a, then fill-in ‘$0’ in Table 1.b.

***Membership includes all services specified in the Statement of Work. The Government and individual traveler shall not be responsible for any additional costs beyond those expressly provided for under this membership.

2. NASA Identified Independent Traveler Membership Pricing NASA has a requirement for a select number of NASA identified independent travelers to receive the same requirements stated in this contract, but are not included in travel days identified in the pricing tables in section 1. The pre-paid requirements and services for these travelers will not be charged to NASA, nor counted towards fulfillment of NASA requirements. The enrollment will be established and paid for directly between the traveler and the Contractor without NASA involvement. The pricing in the following tables is valid for the entirety of the contract.

2.a Pre-Paid Membership Price for NASA Identified Independent Traveler (excluding Portable Medical Isolation Unit Evacuations)

2.b OPTIONAL*: Pre-Paid Membership Price for NASA Identified Independent Traveler for Medevac Using Portable Medical Isolation Unit (e.g. infectious disease medevac)**

* The Traveler may request medevac coverage using a Portable Medical Isolation Unit (e.g. infectious disease medevac).

** Prices in Table 2.b represent the delta price from the standard air ambulance coverage, priced in Table 2.a, to provide a medevac using a Portable Medical Isolation Unit (e.g. infectious disease medevac). The sum of the prices identified in 2.a and 2.b represent the total price for the period for medevac coverage that includes using Portable Medical Isolation Unit (e.g. infectious disease medevac).

*** Includes the NASA Identified Independent Traveler, spouse or domestic partner, and all dependent children.

3. Advance Reservation and Call-up/Execution of Medical Transport via Air Ambulance for Traveler NASA may require a reservation of medical transport via air ambulance in advance of an event or activity. As needed, NASA will unilaterally issue a revision to this order for the reservation utilizing the price listed in Table 3.a. If this medical transport via air ambulance, which is determined solely by the Government, is called-up and executed after reservation, NASA will pay the price listed in Table 3.b for the occurrence. All additional costs shall be the responsibility of the Contractor and no additional cost beyond the Table 3.a price per reservation fee, and Table 3.b, if executed, will be incurred by NASA. The advance reservation and possible subsequent medical transport via air ambulance will be unilaterally determined by the Government and shall result in a modification to the contract to update clause 1. CONTRACT VALUE AND CONTRACT FUNDING.

The pricing in the following tables is valid for the entirety of the contract.

3a. OPTIONAL: Price for Reservation of Medical Transport via Air Ambulance for Traveler*

3b. OPTIONAL: Price for Call-Up/Execution of Medical Transport via Air Ambulance for Traveler*, **

* The advance reservation and subsequent medical transport via air ambulance is unilaterally determined by the Government. The Government and individual travelers shall not be responsible for any additional costs beyond those listed in Table 3.a or Table 3.b for the respective optional service(s).

** Once a NASA flight surgeon determines the traveler is fit-to-fly, there is no requirement for an observation or stabilization period at a local medical facility prior to medical transport via air ambulance.