CLARKSBURG.PRICING.AMEND3.xls

XLS spreadsheet 164 KB Posted Mar 31, 2011

Attached to: FITNESS FOR DUTY PHYSICAL EXAMS
Solicitation number: RFQ-OSCU-FFDPE2011
Issued by: Department of Justice Federal Bureau of Investigation Headquarters Division

About this file

From the source

CLARKSBURG PRICE MATRIX

View the file

Other files

File	Type	Posted
AWARD_NOTICE_FFD2011.docx	DOCX document	Aug 30, 2011
AWARD NOTICE FFD2011.docx	DOCX document	Jul 26, 2011
CINCINNATI.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
HONOLULU.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
MOBILE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SANTAANA.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
RALEIGH.PRICING.AMEND.4.xls	XLS spreadsheet	Apr 12, 2011
AL.PRICING.amend4.xls	XLS spreadsheet	Apr 12, 2011
QUANTICO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SANJOSE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
RICHMOND.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
CLEVELAND.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
AUSTIN.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SANANTONIO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SACRAMENTO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
LOUISVILLE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
JACKSON.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
RIVERSIDE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SALTLAKE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
OMAHA.PRICING.AMEND.4.xls	XLS spreadsheet	Apr 12, 2011
INDIANAPOLIS.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
CLARKSBURG.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
LITTLEROCK.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
DETROIT.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
COLUMBIA.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
ORLANDO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
CHARLESTON.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
ST. LOUIS.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SEATTLE.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
SANFRAN.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
BUFFALO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
FRESNO.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
MIAMI.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
amend4.doc	DOC document	Apr 12, 2011
KCITY.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
LASVEGAS.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
MCALLEN.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
COLUMBUS.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
DALLAS.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
TAMPA.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
AT.CITY PRICING. AMEND.4.xls	XLS spreadsheet	Apr 12, 2011
BIRMINGHAM.PRICING.AMEND4.xls	XLS spreadsheet	Apr 12, 2011
Q A FFD2011.doc	DOC document	Apr 12, 2011
FD-484.pdf	PDF	Mar 31, 2011
fd-816.pdf	PDF	Mar 31, 2011
QUESTIONS.doc	DOC document	Mar 31, 2011
SECTION III. SOW. AMEND3.doc	DOC document	Mar 31, 2011
MIAMI.PRICING.AMEND3.xls	XLS spreadsheet	Mar 31, 2011
RALEIGH.PRICING.AMEND.3.xls	XLS spreadsheet	Mar 31, 2011
COLUMBIA.PRICING.AMEND3.xls	XLS spreadsheet	Mar 31, 2011

Show 40 more

Latest 50 of 168 listed here. See the rest on GovTribe.

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Sheet1

RFP-OSCU-FFDPE2011 PRICING MATRIX

**revised per amendment 3**

SECTION A

LOCATION:

CLARKSBURG, WEST VIRGINIA

****INSTRUCTIONS****

VENDOR NAME:

Point of Contact:

Phone :

1) Proposed pricing shall be submitted utilizing this form.

Below is the estimated number of each exam per category per year

2) No other pricing format, form, or notations will be accepted.

Pre-Employment (Applicant) Physical Examinations

3) Any line item that is left blank may be viewed as Non-Responsive. If a particular

Fitness for Duty (FFD) Periodic Examinations (On-Board)

service is not available, please indicate as N/A. If a line item is included in the price of

Cardiovascular (Stress) Tests - Bruce or Balke Protocols

another line item, please explain.

Department of State/Embassy Personnel (LEGAT) Physical Examinations

4) Offerors shall complete and submit one pricing matrix for each proposed location.

Hazardous Materials Response Unit (HMRU) Examinations

5) Please provide a price for all exams, including those estimated at zero (0), if available.

Department of Transportation Physical Exams for Commercial Drivers

6) Items marked with "***" are not required services; however, if pricing is service is available, please indicate pricing

Respiratory Protection Examinations

Hazardous Device School Examinations

Diver Examinations - Navy Dive (NOAA) Standards

10.

Language Specialists - Audiometric Surveillance

11.

Federal Aviation Administration (FAA) Pilot Examinations***

SECTION B

VENDOR MUST COMPLETE ALL OPEN CELLS

Pre-Employment (Applicant) Physical Examination

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type refer to FD 945

Pricing should reflect REQUIRED components only - No Special Circumstance Components

Multiply unit price by number of pre-employment physicals in Section A above

$0.00

Fitness for Duty (FFD) Periodic Examinations (On-Board)

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing this exam, Refer to FD 943

Pricing should reflect REQUIRED components only - No Special Circumstance Components

Multiply unit price by number of Fitness for duty Periodic Exams in Section A above

$0.00

Cardiovascular (Stress) Tests - Brucs/Balke protocol

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type refer to FD 943

Multiply unit price by number of cardiovascular stress tests in Section A above

$0.00

Department of State/Embassy Personnel (LEGAT) Physical Examinations

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing this exam, Refer to FD 949

Pricing should reflect REQUIRED components only - No Special Circumstance Components

Multiply unit price by number of Department of State examinations in Section A above

$0.00

Hazardous Materials Response Unit (HMRU) Examination - Initial

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type refer to FD 944

Pricing should reflect REQUIRED components only - No Special Circumstance Components

Multiply unit price by number of HMRU exams in Section A above

$0.00

Department of Transportation Physical Exams for Commercial Drivers

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter total price for perfroming one of this exam type refer to FD-964

Multiply unit price by number of Department of Transportation Exams in Section A above

$0.00

Respiratory Protection Exam - Initial

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for perfominig one of this exam type, refer to FD-946, 900 and 899

Multiply unit price by numbr of Respiratory Protection Exams in Section A above

$0.00

Hazardous Device School

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type, refer to FD 965

Multiply unit price by number of Hazardous Device School Exams in Section A above

$0.00

FBI Dive Examinations - Navy Dive (NOAA) Standards

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type , refer to FD 966

Multiply unit price by number of FBI Dive Exams in Section A above

$0.00

10.

Language Specialists - Audiometric Surveillance Examinations

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type, refer to section III.14.1

Multiply unit price by number of Language Specialist Exams in Section A above

$0.00

11.

Federal Aviation Administration (FAA) Class 1 Examinations***

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for performing one of this exam type, refer to FD 963

Multiply unit price by number of FAA examiniations in Section A above

$0.00

***NOT REQUIRED; HOWEVER, IF SERVICE IS AVAILABLE, PLEASE PROVIDE PRICING***

TOTAL LINES 24, 29, 33, 38, 43, 47, 51, 55, 59, and 63

$0.00

12.

Immunizations

- FBI SUPPLIED

CPT Code

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for each injection listed below with FBI Supplied Serum

**ASSUME A QUANTITY OF ONE**

Standard

a. Polio (IPV)

i. w/FBI supplied serum

90471

b. MMR booster (born 1957 +)

i. w/FBI supplied serum

90471

c. Tetanus/Diptheria booster (every 10 years)

i. w/FBI supplied serum

90471

d. Tdap tetanus/Diptheria/Pertussis

i. w/FBI supplied serum

90471

e. Hepatitis A (per shot)

i. w/FBI supplied serum

90471

f. Hepatitis B (per shot)

i. w/FBI supplied serum

90471

g. Typhoid - Oral

i. FBI supplied

90473

h. Typhoid - IM

i. w/FBI supplied serum

90471

i. Influenza - IM

i. w/FBI supplied serum

90471

j. Influenza - Intranasal

i. w/FBI supplied serum

90471

k. Twinvax (Twinrix)

i. w/FBI supplied serum

90471

Special Use

a. Meningococcal Vaccine

i. w/FBI supplied serum

90471

b. Yellow Fever

i. w/FBI supplied serum

90471

c. Rabies Vaccine (per shot)

i. w/FBI supplied serum

90471

d. Japanese B Encephalitis

i. w/FBI supplied serum

90471

d. Anthrax Vaccine

i. w/FBI supplied serum

90471

e. Botulinum Toxin Vaccine

i. w/FBI supplied serum

90471

TOTAL LINES 75 - 94

$0.00

Immunizations - VENDOR SUPPLIED

CPT Code

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

Enter unit price for each injection listed below with Vendor Supplied Serum if available.

**ASSUME A QUANTITY OF ONE**

Standard

a. Polio (IPV)

i. vendor supplied serum

90471/90713

b. MMR booster (born 1957 +)

i. vendor supplied serum

90471/90707

c. Tetanus/Diptheria booster (every 10 years)

i. vendor supplied serum

90471/90718

d. Tdap tetanus/Diptheria/Pertussis

i. vendor supplied serum

90471/90715

e. Hepatitis A (per shot)

i. vendor supplied serum

90471/90632

f. Hepatitis B (per shot)

i. vendor supplied serum

90471/90746

g. Typhoid - Oral

i. vendor supplied

90473/90690

h. Typhoid - IM

i. vendor supplied serum

90471/90691

i. Influenza - IM

i. vendor supplied serum

90471/90658

j. Influenza - Intranasal

i. vendor supplied serum

90471

k. Twinvax (Twinrix)/shot

i. vendor supplied serum

90471/90636

Special Use

a. Meningococcal Vaccine

i. vendor supplied serum

90471/90733-4

b. Yellow Fever

i. vendor supplied serum

90471/90717

c. Rabies Vaccine (per shot)

i. vendor supplied serum

90471/90675

d. Japanese B Encephalitis

N/A - FBI Supplied

d. Anthrax Vaccine per shot

N/A - FBI Supplied

e. Botulinum Toxin Vaccine

N/A - FBI Supplied

TOTAL LINES 100-116

$0.00

13a

Travel Medicines

**ASSUME A QUANTITY OF ONE**

Enter unit price of travel medicines below - Vendor Supplied Medications or Prescriptions

Malaria

i. Malarone

Consult/Prescription

4120F

Consult/Medications

4120F

ii. Doxycycline

Consult/Prescription

4120F

Consult/Medications

4120F

iii. Mefloquine

Consult/Prescription

4120F

Consult/Medications

4120F

Antibiotics forTravelers' Diarrhea

Consult/Prescription

4120F

Consult/Medications

4120F

Sleep Aid Medications

Consult/Prescription

4120F

Consult/Medications

4120F

TOTAL LINES 126-137

$0.00

14.

Additional Individual Testing as Requested

CPT Code

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

**ASSUME A QUANTITY OF ONE**

a. ALT

84460

b. Audiometry

92551

c. Blood group and type

86900, 01

d. Blood Lead-age 9 mos. through 6 years

83655

e. Blood Lead & ZPP - Adult - (if authorized by HCPU)

84202/83655

f. Blood renal and metabolic panels

80053

g. Chest X-ray, PA/LAT

71020

h. Colonoscopy - per approval ***

45378

i. Complete GYN Exam w/ PAP as indicated

88141

j. Completion of Respiratory Questionnaire

FD-900

k. Creatinine

82565

l. Digital Rectal Exam, Male > 40- offer

45999

m. Distant and Near Visual Acuity, w & w/o correction

99172

n. Electrocardiogram w/interpretation

93000

o. Fasting Blood Glucose

82947

p. Complete blood count with diff

85025

q. CXR - P/A and lateral

71020

r. Mantoux skin test & interruptation

86580

s. Flexible Sigmoidoscopy - per approval***

45330

t. G6PD, if not previously done

82955

u. GGT & Uric Acid

82977/84550

s. HbA1C

83036

a. Urinalysis

81001

t. Hepatitis B Antibody and Antigen

87340/86706

b. Stool for occult blood X 3 - offer

82270

v. Hepatitis C antibody

86803

w. History, physical exam, vitals, written summary

99395,96,97

x. HIV, I & II Elisa

87390/87391

y. Intraocular Tension (IOT) > 40 years of age

92120

z. Lipid panel

80061

aa. Mammogram (as indicated)

77057

bb. Prostate specific antigen (PSA)

84153

cc. Pulmonary function test

94010

dd. RBC Cholinesterase x 1 draw

82482

ee. Serology, RPR

86592

ff. Sickle Cell-Mediterranean or Black only

85660

gg. Stool for occult blood x's 3

82270

hh. Stool for Ova & Parasites (as indicated)

87177

ii. UA and micro.

81001

jj. Visual fields Strabismus, Color Vision

99172

kk. cardiologist over read of EKG

99499

ll. Chest x-ray over read by radiologist

76499

mm. IGRA as alternative to tubercullin skin tests***

86480

nn. Thallium/Nuclear SPECT Stress Test

93015

, 78451, 78452

nn. Cont'd

A9505, A9502

oo. Stress Echocardiogram

93350, 93018

pp. FAA Class II Examination***

FD-963

qq. FAA Class III Examination***

FD-963

rr. Opthalmology/Optometry Examination***

FD-943

TOTAL LINES 141-184

$0.00

15.

Hourly Rate for Expert Testimony

CPT Code

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

99075

16.

Hourly Rate for Medical Consultation and Training

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

99078

*Total Pricing Per Year - sum of lines 71,95,138,188,191, & 194*

Base Year

YEAR 1

YEAR 2

YEAR 3

YEAR 4

$0.00

*GRAND TOTAL FOR ALL FIVE YEARS* -

$0.00

Page &P Page &P Page &P

Sheet2

Sheet3

File details come from the government source that posted it. Updated Nov 14, 2017.