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Instructions
| Official Solicitation Price Sheet |
| S000000394 Mental Health Services |
| Instructions |
| 1. Prospective Contractors should enter Prospective Contractor name in the blue-highlighted cell on the Pricing tab. |
| Table 1 |
| 1. Prospective Contractors shall identify the total four (4) year grand total cost for the service. |
| 2. This cost must include all costs associated with the activities and tasks that meet the Requirements of the RFP and all additional activities and tasks identified in the Prospective Contractor's proposal. |
| 3. Prospective Contractors shall enter the total cost in the blue-highlighted cell in Table 1. |
| 4. Cost Points will be awarded based on the total cost provided in Table 1. |
| Table 2 |
| 1. Prospective Contractors should provide a cost breakdown to complete each activity and task identified in the RFP, in the Prospective Contractor's proposal, and included in the total cost. |
| 2. Prospective Contractors should provide the description, per unit cost, unit of measurement, and estimated number of units for each activity and task; the total costs will automatically populate. |
| 3. Prospective Contractors may add lines to Table 2 as needed. |
| 4. The total cost from Table 2 must match the total cost provided in Table 1. |
| 5. In the event of a discrepancy between Tables 1 and 2, Table 1 shall govern. |
| 6. As requested by the State, Prospective Contractors shall provide further breakdown of identified cost during the Discussion Phase. The cost must not exceed what is identified in Table 1. |
| Table 3 |
| 1. Prospective Contracts shall identify the subsequent fifth, sixth, and seventh year costs for the service. |
| 2. Prospective Contractors should provide a cost breakdown to complete each activity and task identified in the RFP, in the Prospective Contractor's proposal. |
| 3. Prospective Contractors should provide the description, per unit cost, unit of measurement, and estimated number of units for each activity and task; the total costs will automatically populate. |
| 4. Prospective Contractors may add lines to Table 3 as needed. |
| 5. As requested by the State, Prospective Contractors shall provide further breakdown of identified cost during the Discussion Phase. |
| 6. Table 3 will not be included in the scoring of the Total Estimated Cost. |
Pricing
| Official Solicitation Price Sheet |
| S000000394 Mental Health Referral Services |
| Prospective Contractor Name: |
| TABLE 1: (to be used in determing Cost Points) | |
| Description | Total Four-Year Grand Total |
| Mental Health Referral Services | |
| TABLE 2: COST BREAKDOWN (must match costs identified in Table 1) | | | | | |
| Description | Year One | Year Two | Year Three | Year Four | Total Cost |
| Ex: Implementation Fee | | | | | $ - 0 |
| Ex: Consulting Fee | | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| | | | | $ - 0 |
| TOTAL | | | | | $ - 0 |
| *For any estimations, please base your cost on 1,000 students/referrals (All school districts). | | | | | |
This number is for costing purposes only, the actual number may be much greater.
| Table 3: Cost Breakdown (will not be used in scoring determination) | | | | |
| Description | Year Five | Year Six | Year Seven | Total Cost |
| Ex: Implementation Fee | | | | $ - 0 |
| Ex: Consulting Fee | | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| | | | $ - 0 |
| TOTAL | | | | $ - 0 |