S02 D.3 Fillable Schedule of Services - Locum GI Physician Services.xlsx
XLSX spreadsheet 22 KB Posted
- Solicitation number
- 36C25726Q0159
About this file
This is a fillable Schedule of Services pricing template for locum Gastroenterology (GI) physician services under RFQ 36C25726Q0159. The template is designed for contractors to submit pricing for on-site and on-call GI physician services at the South Texas Veterans Health Care System, with service periods spanning a base year (April 1, 2026 to March 31, 2027) and four optional years extending through March 31, 2031.
The pricing structure includes three line items for each contract period: on-site Board Certified/Board Eligible GI physician services (9,181 estimated hours annually with provisions for up to eight key personnel), on-call GI physician availability (3,868 estimated hours annually), and call-back services when on-call providers are required to report on-site (180 estimated hours annually). Contractors must provide hourly unit costs for each service category, with call-back coverage compensated at the on-call provider's hourly rate. The template is currently blank with all pricing fields showing $0, requiring offerors to complete unit costs and calculate total annual costs for each line item across all five contract periods to arrive at the estimated grand total. This is a template document requiring contractor pricing input and is not a completed pricing submission.
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Text version
Base Year D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
| Base Year - 04-01-2026 to 03-31-2027 | |||||||
| LIN No. | SLIN No. | Description of Services | Estimated Quantity | Unit | Unit Cost | Total Annual Cost | |
| 0001 | None | On-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS. | 9181 | Hour (HR) | |||
| Key Personnel | |||||||
| 0001a | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001b | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001c | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001d | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001e | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001f | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001g | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 0001h | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| LIN 0001 Total | $ - 0 | ||||||
| 0002 | None | On-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call-back coverage shall be paid at providers hourly rate included in LIN 0003. | 3868 | HR | $ - 0 | $ - 0 | |
| LIN 0002 Total | $ - 0 | ||||||
| 0003 | None | Call-Back Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services. | 180 | HR | $ - 0 | $ - 0 | |
| LIN 0003 Total | $ - 0 | ||||||
| Estimated Base Year Total | $ - 0 |
Option Year One D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
| Option Year One - 04-01-2027 to 03-31-2028 | |||||||
| LIN No. | SLIN No. | Description of Services | Estimated Quantity | Unit | Unit Cost | Total Annual Cost | |
| 1001 | None | On-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS. | 9181 | Hour (HR) | |||
| Key Personnel | |||||||
| 1001a | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001b | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001c | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001d | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001e | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001f | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001g | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 1001h | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| LIN 1001 Total | $ - 0 | ||||||
| 1002 | None | On-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003. | 3868 | HR | $ - 0 | $ - 0 | |
| LIN 1002 Total | $ - 0 | ||||||
| 1003 | None | CallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services. | 180 | HR | $ - 0 | $ - 0 | |
| LIN 1003 Total | $ - 0 | ||||||
| Estimated Option Year One Total | $ - 0 |
Option Year Two D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
| Option Year Two - 04-01-2028 to 03-31-2029 | |||||||
| LIN No. | SLIN No. | Description of Services | Estimated Quantity | Unit | Unit Cost | Total Annual Cost | |
| 2001 | None | On-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS. | 9181 | Hour (HR) | |||
| Key Personnel | |||||||
| 2001a | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001b | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001c | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001d | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001e | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001f | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001g | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 2001h | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| LIN 2001 Total | $ - 0 | ||||||
| 2002 | None | On-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003. | 3868 | HR | $ - 0 | $ - 0 | |
| LIN 2002 Total | $ - 0 | ||||||
| 2003 | None | CallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services. | 180 | HR | $ - 0 | $ - 0 | |
| LIN 2003 Total | $ - 0 | ||||||
| Estimated Option Year Two Total | $ - 0 |
Option Year Three D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
| Option Year Three - 04-01-2029 to 03-31-2030 | |||||||
| LIN No. | SLIN No. | Description of Services | Estimated Quantity | Unit | Unit Cost | Total Annual Cost | |
| 3001 | None | On-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS. | 9181 | Hour (HR) | |||
| Key Personnel | |||||||
| 3001a | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001b | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001c | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001d | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001e | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001f | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001g | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 3001h | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| LIN 3001 Total | $ - 0 | ||||||
| 3002 | None | On-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003. | 3868 | HR | $ - 0 | $ - 0 | |
| LIN 3002 Total | $ - 0 | ||||||
| 3003 | None | CallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services. | 180 | HR | $ - 0 | $ - 0 | |
| LIN 3003 Total | $ - 0 | ||||||
| Estimated Option Year Three Total | $ - 0 |
Option Year Four D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
| Option Year Four - 04-01-2030 to 03-31-2031 | |||||||
| LIN No. | SLIN No. | Description of Services | Estimated Quantity | Unit | Unit Cost | Total Annual Cost | |
| 4001 | None | On-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS. | 9181 | Hour (HR) | |||
| Key Personnel | |||||||
| 4001a | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001b | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001c | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001d | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001e | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001f | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001g | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| 4001h | Name: | ||||||
| Title: | 0 | HR | $ - 0 | $ - 0 | |||
| LIN 4001 Total | $ - 0 | ||||||
| 4002 | None | On-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003. | 3868 | HR | $ - 0 | $ - 0 | |
| LIN 4002 Total | $ - 0 | ||||||
| 4003 | None | CallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services. | 180 | HR | $ - 0 | $ - 0 | |
| LIN 4003 Total | $ - 0 | ||||||
| Estimated Option Year Four Total | $ - 0 |
Estimated Grand Total
| D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159 | |
| Base Year | $ - 0 |
| Option Year One | $ - 0 |
| Option Year Two | $ - 0 |
| Option Year Three | $ - 0 |
| Option Year Four | $ - 0 |
| Estimated Grand Total | $ - 0 |
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