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PRICE SCHEDULE
ROSEBUD COMPREHENSIVE HEALTH CARE FACILITY
Radiology Interpretation and On-Site Services
BASE YEAR:
| ITEM # |
| DESCRIPTION |
| ESTIMATED QUANTITY |
| UNIT OF ISSUE |
| UNIT COST |
| TOTAL COST |
| 1. |
| Radiology Interpretation & On-Site Services |
| 12 |
| Months |
| $ ___________ |
| $ ___________ |
| GRAND |
| TOTAL |
| FOR |
| BASE YEAR: |
| $ ___________ |
OPTION YEAR ONE (1):
| ITEM # |
| DESCRIPTION |
| ESTIMATED QUANTITY |
| UNIT OF ISSUE |
| UNIT COST |
| TOTAL COST |
| 2. |
| Radiology Interpretation & On-Site Services |
| 12 |
| Months |
| $ ___________ |
| $ ___________ |
| GRAND |
| TOTAL |
| FOR |
| OPTION YR ONE (1): |
| $ ___________ |
OPTION YEAR TWO (2):
| ITEM # |
| DESCRIPTION |
| ESTIMATED QUANTITY |
| UNIT OF ISSUE |
| UNIT COST |
| TOTAL COST |
| 3. |
| Radiology Interpretation & On-Site Services |
| 12 |
| Months |
| $ ___________ |
| $ ___________ |
| GRAND |
| TOTAL |
| FOR |
| OPTION YR TWO (2): |
| $ ___________ |
OPTION YEAR THREE (3):
| ITEM # |
| DESCRIPTION |
| ESTIMATED QUANTITY |
| UNIT OF ISSUE |
| UNIT COST |
| TOTAL COST |
| 4. |
| Radiology Interpretation & On-Site Services |
| 12 |
| Months |
| $ ___________ |
| $ ___________ |
| GRAND |
| TOTAL |
| FOR |
| OPTION YR THREE (3): |
| $ ___________ |
OPTION YEAR FOUR (4):
| ITEM # |
| DESCRIPTION |
| ESTIMATED QUANTITY |
| UNIT OF ISSUE |
| UNIT COST |
| TOTAL COST |
| 5. |
| Radiology Interpretation & On-Site Services |
| 12 |
| Months |
| $ ___________ |
| $ ___________ |
| GRAND |
| TOTAL |
| FOR |
| OPTION YR FOUR (4): |
| $ ___________ |
GRAND TOTAL
FOR BASE + ALL FOUR (4) OPTION YEARS: $ _______________________
