S02 D.3 Fillable Schedule of Services - Locum GI Physician Services.xlsx

XLSX spreadsheet 22 KB Posted

Attached to
Q505--Locum Gastroenterology (GI) Physician Services MSO-2026-COM-0017
Solicitation number
36C25726Q0159
Issued by

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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Other files

File Type Posted
36C25726Q0159 0004.docx DOCX document
S02 36C25726Q0159 - Locum GI Physician Services - Unrestricted Insufficient Small Businesses.docx DOCX document
36C25726Q0159 0003.docx DOCX document
S02 D.3 Fillable Schedule of Services - Locum GI Physician Services - 05-28-2026.xlsx XLSX spreadsheet
S02 D.8 VHA Bookable Hour and Appointment Length Standards Memorandum - 05-28-2026.pdf PDF
S02 D.5 Contractor Rules of Behavior - 05-28-2026.docx DOCX document
S02 D.6 Contractor Certification - Immigration and Nationality Act - 05-28-2026.docx DOCX document
S02 D.7 Organizational Conflicts of Interest - 05-28-2026.docx DOCX document
S02 D.4 Past Performance Questionnaire Worksheet - Locum GI Physician Services - 05-28-2026.docx DOCX document
S02 D.1 Quality Assurance Surveillance Plan - Locum GI Physician Services - 05-28-2026.docx DOCX document
36C25726Q0159 0002.docx DOCX document
36C25726Q0159 0001.docx DOCX document
S02 D.5 Contractor Rules of Behavior.docx DOCX document
S02 D.8 VHA Bookable Hour and Appointment Length Standards Memorandum.pdf PDF
S02 D.4 Past Performance Questionnaire Worksheet - Locum GI Physician Services.docx DOCX document
S02 D.7 Organizational Conflicts of Interest.docx DOCX document
S02 D.1 Quality Assurance Surveillance Plan - Locum GI Physician Services.docx DOCX document
36C25726Q0159_1.docx DOCX document
S02 D.6 Contractor Certification - Immigration and Nationality Act.docx DOCX document
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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 ServicesEstimated QuantityUnitUnit CostTotal Annual Cost
0001NoneOn-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.9181Hour (HR)
Key Personnel
0001aName:
Title:0HR$ - 0$ - 0
0001bName:
Title:0HR$ - 0$ - 0
0001cName:
Title:0HR$ - 0$ - 0
0001dName:
Title:0HR$ - 0$ - 0
0001eName:
Title:0HR$ - 0$ - 0
0001fName:
Title:0HR$ - 0$ - 0
0001gName:
Title:0HR$ - 0$ - 0
0001hName:
Title:0HR$ - 0$ - 0
LIN 0001 Total$ - 0
0002NoneOn-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 0003.3868HR$ - 0$ - 0
LIN 0002 Total$ - 0
0003NoneCall-Back Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 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 ServicesEstimated QuantityUnitUnit CostTotal Annual Cost
1001NoneOn-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.9181Hour (HR)
Key Personnel
1001aName:
Title:0HR$ - 0$ - 0
1001bName:
Title:0HR$ - 0$ - 0
1001cName:
Title:0HR$ - 0$ - 0
1001dName:
Title:0HR$ - 0$ - 0
1001eName:
Title:0HR$ - 0$ - 0
1001fName:
Title:0HR$ - 0$ - 0
1001gName:
Title:0HR$ - 0$ - 0
1001hName:
Title:0HR$ - 0$ - 0
LIN 1001 Total$ - 0
1002NoneOn-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 0003.3868HR$ - 0$ - 0
LIN 1002 Total$ - 0
1003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 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 ServicesEstimated QuantityUnitUnit CostTotal Annual Cost
2001NoneOn-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.9181Hour (HR)
Key Personnel
2001aName:
Title:0HR$ - 0$ - 0
2001bName:
Title:0HR$ - 0$ - 0
2001cName:
Title:0HR$ - 0$ - 0
2001dName:
Title:0HR$ - 0$ - 0
2001eName:
Title:0HR$ - 0$ - 0
2001fName:
Title:0HR$ - 0$ - 0
2001gName:
Title:0HR$ - 0$ - 0
2001hName:
Title:0HR$ - 0$ - 0
LIN 2001 Total$ - 0
2002NoneOn-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 0003.3868HR$ - 0$ - 0
LIN 2002 Total$ - 0
2003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 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 ServicesEstimated QuantityUnitUnit CostTotal Annual Cost
3001NoneOn-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.9181Hour (HR)
Key Personnel
3001aName:
Title:0HR$ - 0$ - 0
3001bName:
Title:0HR$ - 0$ - 0
3001cName:
Title:0HR$ - 0$ - 0
3001dName:
Title:0HR$ - 0$ - 0
3001eName:
Title:0HR$ - 0$ - 0
3001fName:
Title:0HR$ - 0$ - 0
3001gName:
Title:0HR$ - 0$ - 0
3001hName:
Title:0HR$ - 0$ - 0
LIN 3001 Total$ - 0
3002NoneOn-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 0003.3868HR$ - 0$ - 0
LIN 3002 Total$ - 0
3003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 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 ServicesEstimated QuantityUnitUnit CostTotal Annual Cost
4001NoneOn-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.9181Hour (HR)
Key Personnel
4001aName:
Title:0HR$ - 0$ - 0
4001bName:
Title:0HR$ - 0$ - 0
4001cName:
Title:0HR$ - 0$ - 0
4001dName:
Title:0HR$ - 0$ - 0
4001eName:
Title:0HR$ - 0$ - 0
4001fName:
Title:0HR$ - 0$ - 0
4001gName:
Title:0HR$ - 0$ - 0
4001hName:
Title:0HR$ - 0$ - 0
LIN 4001 Total$ - 0
4002NoneOn-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 0003.3868HR$ - 0$ - 0
LIN 4002 Total$ - 0
4003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 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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