SF-1449 Dallas TX 15BCTS26Q00000001.pdf

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Attached to
SU/MH/SOT in Dallas, TX Federal contract opportunity
Solicitation number
15BCTS26Q00000001
Issued by
Department of Justice Bureau of Prisons Central Office

About this file

This is a Request for Quote (RFQ) for Substance Use, Mental Health, and Sex Offender Treatment Services in Dallas, Texas, issued by the Federal Bureau of Prisons, Community Treatment Services Contracting.

The solicitation number is 15BCTS26Q00000001, with quotes due by March 9, 2026 at 2:00 PM ET. The contract is a Firm Fixed Price, Indefinite Delivery Indefinite Quantity (IDIQ) award with a delivery date of May 1, 2026. This is a small business set-aside (100%) with a size standard of $19,000,000. The contracting officer is Wade O'Quinn (woquinn@bop.gov, 276-546-0150 ext. 4144). Quotes must be submitted electronically via email in PDF format with separate file attachments for the completed SF-1449, Business Quotation Information Packet, Technical Quotation Information Packet, Attachment Quotation Form, Pricing Chart, SAM registration proof, Professional Liability Insurance certificate ($1 million minimum per occurrence), and ATU Vendor Attestation Form. Offerors must have an active SAM registration at time of submission; failure to provide any required documentation will result in exclusion from consideration.

The contract covers 114 line items organized into a base period (12 months), four option years (12 months each), and a potential six-month extension. Services include Substance Use Disorder treatment (planning, screening, intake assessment, individual counseling, group counseling, relationship/parenting counseling); Mental Health services (treatment planning, screening, intake assessment, psychiatric evaluation, crisis intervention, individual counseling, medication monitoring); and Sex Offender treatment services (intake assessment, treatment planning, screening, individual counseling). Estimated quantities for each service vary by period, with guaranteed minimums specified. Payment will be made by the Federal Bureau of Prisons South Central Regional Office in Grand Prairie, Texas. Award is contingent on funds availability. Standard FAR clauses apply, including small business utilization, service contract labor standards, employment eligibility verification, and personnel security requirements for contractor employees requiring access to DOJ information and facilities.

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Other files for this federal contract opportunity

Other files attached to SU/MH/SOT in Dallas, TX, newest first.
File Type Posted
Questions for 15BCTS26Q00000001 (CTS in Dallas TX) 2 3-5-26.pdf PDF
Questions for 15BCTS26Q00000001 (CTS in Dallas TX) 1.pdf PDF
Cover Letter Dallas Texas.pdf PDF
Technical Quotation Information Packet Dallas TX.docx DOCX document
Business Quotation Information Packet.pdf PDF
2022 STATEMENT OF WORK (SOW).pdf PDF
APN 22-03 Whistleblower Information.pdf PDF
Attachment Quotation Form.xlsx XLSX spreadsheet
Pricing Chart.pdf PDF
ATU Vendor Attestation.pdf PDF

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15BCTS26Q00000001 Page 1 of 54

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 AND 30.

1. REQUISITION NUMBER PAGE 1 OF

5. SOLICITATION NUMBER

15BCTS26Q00000001

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

02/06/2026

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Wade O'Quinn woquinn@bop.gov

b. TELEPHONE NUMBER (No collect calls)

276-546-0150 ext. 4144

8. OFFER DUE DATE / LOCAL

TIME

03/09/2026 14:00 ET

CODE 15BCTS

Federal Bureau of Prisons

Community Treatment Services Contracting

320 First Street NW

Suite 901-5

Washington, DC 20534

9. ISSUED BY UNRESTRICTED OR X SET ASIDE:100.00 % FOR

X SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL BUSINESS

(EDWOSB)

8(A)

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

621420

SIZE STANDARD:

$19,000,000

10. THE ACQUISITION IS

SEE SCHEDULE

11. DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER THE

DEFENSE PRIORITIES AND

ALLOCATIONS SYSTEM -

DPAS (15 CFR 700)

13b. RATING

X REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

14. METHOD OF SOLICITATION

CODE15. DELIVER TO CODE 15BCTS16. ADMINISTERED BY

Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Suite 901-5 Washington, DC 20534

Wade O'Quinn

(O) 276-546-0150 Ext. 4144 woquinn@bop.gov

FACILITY

CODE

CODE

TELEPHONE NUMBER

17a. CONTRACTOR/

OFFEROR

15B500CODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons South Central Regional Office 344 Marine Forces Drive Grand Prairie, TX 75051

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Delivery Date: 05/01/2026

Substance Use, Mental Health, and Sex Offender Treatment Services in Dallas, TX.

Firm Fixed Price

See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Government Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

ARE X ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REFERENCE _____________________________

OFFER DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK

5) INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (Type or print)

Wade Oquinn

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

001-26

15BCTS26Q00000001 Page 2 of 54

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

PARTIAL FINAL

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

COMPLETE PARTIAL FINAL

36. PAYMENT 37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 11/2021) BACK

15BCTS26Q00000001 Page 3 of 54

Table of Contents

Section Description Page Number

Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses

52.203-3 Gratuities (Apr 1984) 52.203-6 Alt I Restrictions on Subcontractor Sales to the Government (Jun 2020) - Alternate I (Nov 2021) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.203-13 Contractor Code of Business Ethics and Conduct (Nov 2021) 52.204-13 (DEV) System for Award Management-Maintenance (Oct 2018) (DEVIATION NOV 2025) 52.204-19 Incorporation by Reference of Representations and Certifications (Dec 2014) 52.204-27 Prohibition on a ByteDance Covered Application (Jun 2023) 52.204-91 (DEV) Contractor Identification (DEVIATION NOV 2025) 52.209-6 (DEV) Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded (Jan 2025)

(DEVIATION NOV 2025)

52.212-4 (DEV) Terms and Conditions-Commercial Products and Commercial Services (Nov

2023) (DEVIATION NOV 2025)

52.219-8 (DEV) Utilization of Small Business Concerns (Jan 2025) (DEVIATION DEC 2025) 52.219-28 (DEV) Postaward Small Business Program Rerepresentation (Jan 2025)

(DEVIATION DEC 2025)

52.222-3 (DEV) Convict Labor (June 2003) (DEVIATION DEC 2025) 52.222-19 (DEV) Child Labor-Cooperation with Authorities and Remedies (Jan 2025)

(DEVIATION DEC 2025)

52.222-35 (DEV) Equal Opportunity for Veterans (Jun 2020) (DEVIATION DEC 2025) 52.222-36 (DEV) Equal Opportunity for Workers with Disabilities (Jun 2020) (DEVIATION

DEC 2025)

52.222-37 (DEV) Employment Reports on Veterans (Jun 2020) (DEVIATION DEC 2025) 52.222-41 (DEV) Service Contract Labor Standards (Aug 2018) (DEVIATION DEC 2025) 52.222-50 (DEV) Combating Trafficking in Persons (Oct 2025) (DEVIATION DEC 2025) 52.222-54 (DEV) Employment Eligibility Verification (Jan 2025) (DEVIATION DEC 2025) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-3 Privacy Training (Jan 2017) 52.232-33 Payment by Electronic Funds Transfer-System for Award Management (Oct 2018) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.233-3 (DEV) Protest after Award (Aug 1996) (DEVIATION NOV 2025) 52.233-4 (DEV) Applicable Law for Breach of Contract Claim (Oct 2004) (DEVIATION NOV 2025) 52.240-91 (DEV) Security Prohibitions and Exclusions (DEVIATION NOV 2025) 52.242-13 Bankruptcy (July 1995) 52.242-15 Stop-Work Order (Aug 1989) 52.252-6 Authorized Deviations in Clauses (Nov 2020) 52.253-1 (DEV) Computer Generated Forms (Jan 1991) (DEVIATION NOV 2025) 52.209-9 (DEV) Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (DEVIATION NOV 2025) 52.209-10 (DEV) Prohibition on Contracting With Inverted Domestic Corporations (Nov 2015)

(DEVIATION NOV 2025)

52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.232-18 Availability of Funds (Apr 1984)

15BCTS26Q00000001 Page 4 of 54

52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984) 52.237-7 (DEV) Indemnification and Medical Liability Insurance (Jan 1997) (DEVIATION NOV 2025) 52.240-93 (DEV) Basic Safeguarding of Covered Contractor Information Systems

(DEVIATION NOV 2025)

BOP 2852.201-71 Contracting Officer's Representative (COR) (June 2012) BOP DOJ-05 DEVIATION BOP-05 Security of Department Information and Systems (January 2025) DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-02 Contractor Privacy Requirements (JAN 2022) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency (OCT 2007)

3 List of Attachments 4 Solicitation Provisions

52.203-11 Certification And Disclosure Regarding Payments to Influence Certain Federal Transactions (Sept 2024) 52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.204-7 (DEV) System for Award Management-Registration (Nov 2024) (DEVIATION NOV 2025) 52.212-1 (DEV) Instructions to Offerors-Commercial Products and Commercial Services (Sep

2023) (DEVIATION NOV 2025)

52.212-2 (DEV) Evaluation-Commercial Products and Commercial Services (Nov 2021)

(DEVIATION NOV 2025)

52.217-5 (DEV) Evaluation of Options (July 1990) (DEVIATION AUG 2025) 52.219-4 (DEV) Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Oct 2022) (DEVIATION DEC 2025) 52.229-11 (DEV) Tax on Certain Foreign Procurements--Notice and Representation (Jun

2020) (DEVIATION AUG 2025)

52.209-2 (DEV) Prohibition on Contracting with Inverted Domestic Corporations-- Representation (Nov 2015) (DEVIATION NOV 2025) 52.209-7 (DEV) Information Regarding Responsibility Matters (Oct 2018) (DEVIATION NOV 2025) 52.209-11 (DEV) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) (DEVIATION NOV 2025) 52.216-1 (DEV) Type of Contract (Apr 1984) (DEVIATION DEC 2025) 52.240-90 (DEV) Security Prohibitions and Exclusions Representations and Certifications

(DEVIATION NOV 2025)

2852.233-70 Protests Filed Directly with the Department of Justice (NOV 2020)

15BCTS26Q00000001 Page 5 of 54

Section 1 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0001 Substance Use Disorder Treatment Planning and Follow-up (2001)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0002 Substance Use Disorder Intake Screening (2005)

15 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0003 Substance Use Disorder Individual Counseling (2010)

800 Units Guaranteed Minimum; 5400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

5,400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0004 Substance Use Disorder Intake Assessment & Report (2011)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0005 Co-occurring Intake Assessment & Report (2012)

5 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

50 EA $________ $_________________

15BCTS26Q00000001 Page 6 of 54

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0006 Substance Use Disorder Group Counseling (2020)

720 Units Guaranteed Minimum; 5000 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

5,000 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0007 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0008 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0009 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 60 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

60 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0010 Mental Health Intake Assessment & Report (5011)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

75 EA $________ $_________________

15BCTS26Q00000001 Page 7 of 54

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0011 Psychiatric Evaluation & Report (5030)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0012 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 8 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

8 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0013 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 2100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

2,100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0014 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0015 MH- Medication Monitoring & Reporting (6051)

20 Units Guaranteed Minimum; 500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

500 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

15BCTS26Q00000001 Page 8 of 54

0016 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0017 Sex Offender Treatment Disorder Treatment Planning and Follow-up(6001)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0018 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0019 Sex Offender Individual Counseling (6012)

140 Units Guaranteed Minimum; 960 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

960 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0020 Substance Use Disorder Treatment Planning and Follow-up (2001)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0021 Substance Use Disorder Intake Screening (2005)

15 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

50 EA $________ $_________________

15BCTS26Q00000001 Page 9 of 54

Option Year 1: 13 months through 24 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0022 Substance Use Disorder Individual Counseling (2010)

800 Units Guaranteed Minimum; 5400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

5,400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0023 Substance Use Disorder Intake Assessment & Report (2011)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0024 Co-occurring Intake Assessment & Report (2012)

5 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0025 Substance Use Disorder Group Counseling (2020)

720 Units Guaranteed Minimum; 5000 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

5,000 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0026 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

24 EA $________ $_________________

15BCTS26Q00000001 Page 10 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0027 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0028 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 60 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

60 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0029 Mental Health Intake Assessment & Report (5011)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0030 Psychiatric Evaluation & Report (5030)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0031 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 8 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

8 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 11 of 54

0032 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 2100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

2,100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0033 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0034 MH- Medication Monitoring & Reporting (6051)

20 Units Guaranteed Minimum; 500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

500 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0035 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0036 Sex Offender Treatment Disorder Treatment Planning and Follow-up(6001)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0037 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

20 EA $________ $_________________

15BCTS26Q00000001 Page 12 of 54

Option Year 1: 13 months through 24 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0038 Sex Offender Individual Counseling (6012)

140 Units Guaranteed Minimum; 960 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

960 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0039 Substance Use Disorder Treatment Planning and Follow-up (2001)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0040 Substance Use Disorder Intake Screening (2005)

15 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0041 Substance Use Disorder Individual Counseling (2010)

800 Units Guaranteed Minimum; 5400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

5,400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0042 Substance Use Disorder Intake Assessment & Report (2011)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

165 EA $________ $_________________

15BCTS26Q00000001 Page 13 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0043 Co-occurring Intake Assessment & Report (2012)

5 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0044 Substance Use Disorder Group Counseling (2020)

720 Units Guaranteed Minimum; 5000 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

5,000 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0045 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0046 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0047 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 60 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

60 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 14 of 54

0048 Mental Health Intake Assessment & Report (5011)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0049 Psychiatric Evaluation & Report (5030)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0050 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 8 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

8 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0051 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 2100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

2,100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0052 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0053 MH- Medication Monitoring & Reporting (6051)

20 Units Guaranteed Minimum; 500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

500 EA $________ $_________________

15BCTS26Q00000001 Page 15 of 54

Option Year 2: 25 months through 36 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0054 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0055 Sex Offender Treatment Disorder Treatment Planning and Follow-up(6001)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0056 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0057 Sex Offender Individual Counseling (6012)

140 Units Guaranteed Minimum; 960 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

960 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0058 Substance Use Disorder Treatment Planning and Follow-up (2001)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

165 EA $________ $_________________

15BCTS26Q00000001 Page 16 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0059 Substance Use Disorder Intake Screening (2005)

15 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0060 Substance Use Disorder Individual Counseling (2010)

800 Units Guaranteed Minimum; 5400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

5,400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0061 Substance Use Disorder Intake Assessment & Report (2011)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0062 Co-occurring Intake Assessment & Report (2012)

5 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0063 Substance Use Disorder Group Counseling (2020)

720 Units Guaranteed Minimum; 5000 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

5,000 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 17 of 54

0064 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0065 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0066 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 60 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

60 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0067 Mental Health Intake Assessment & Report (5011)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0068 Psychiatric Evaluation & Report (5030)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0069 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 8 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

8 EA $________ $_________________

15BCTS26Q00000001 Page 18 of 54

Option Year 3: 37 months through 48 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0070 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 2100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

2,100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0071 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0072 MH- Medication Monitoring & Reporting (6051)

20 Units Guaranteed Minimum; 500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

500 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0073 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0074 Sex Offender Treatment Disorder Treatment Planning and Follow-up(6001)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

20 EA $________ $_________________

15BCTS26Q00000001 Page 19 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0075 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0076 Sex Offender Individual Counseling (6012)

140 Units Guaranteed Minimum; 960 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

960 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0077 Substance Use Disorder Treatment Planning and Follow-up (2001)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0078 Substance Use Disorder Intake Screening (2005)

15 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0079 Substance Use Disorder Individual Counseling (2010)

800 Units Guaranteed Minimum; 5400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

5,400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 20 of 54

0080 Substance Use Disorder Intake Assessment & Report (2011)

25 Units Guaranteed Minimum; 165 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

165 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0081 Co-occurring Intake Assessment & Report (2012)

5 Units Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0082 Substance Use Disorder Group Counseling (2020)

720 Units Guaranteed Minimum; 5000 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

5,000 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0083 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

24 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0084 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0085 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 60 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

60 EA $________ $_________________

15BCTS26Q00000001 Page 21 of 54

Option Year 4: 49 months through 60 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0086 Mental Health Intake Assessment & Report (5011)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0087 Psychiatric Evaluation & Report (5030)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

75 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0088 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 8 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

8 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0089 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 2100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

2,100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0090 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 24 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

24 EA $________ $_________________

15BCTS26Q00000001 Page 22 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0091 MH- Medication Monitoring & Reporting (6051)

20 Units Guaranteed Minimum; 500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

500 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0092 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0093 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0094 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0095 Sex Offender Individual Counseling (6012)

140 Units Guaranteed Minimum; 960 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

960 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 23 of 54

0096 Substance Use Disorder Treatment Planning and Follow-up (2001)

13 Units Guaranteed Minimum; 83 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

83 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0097 Substance Use Disorder Intake Screening (2005)

8 Units Guaranteed Minimum; 25 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

25 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0098 Substance Use Disorder Individual Counseling (2010)

400 Units Guaranteed Minimum; 2700 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

2,700 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0099 Substance Use Disorder Intake Assessment & Report (2011)

13 Units Guaranteed Minimum; 83 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

83 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0100 Co-occurring Intake Assessment & Report (2012)

3 Units Guaranteed Minimum; 25 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

25 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0101 Substance Use Disorder Group Counseling (2020)

360 Units Guaranteed Minimum; 2500 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

2,500 EA $________ $_________________

15BCTS26Q00000001 Page 24 of 54

Potential 6 Month Extension

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0102 Substance Use Disorder Relationship and Parenting Counseling (2030)

1 Unit Guaranteed Minimum; 12 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0103 Mental Health Treatment Planning and Follow-up (5001)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

38 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0104 Mental Health Intake Screening (5005)

3 Units Guaranteed Minimum; 30 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0105 Mental Health Intake Assessment & Report (5011)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

38 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0106 Psychiatric Evaluation & Report (5030)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

38 EA $________ $_________________

15BCTS26Q00000001 Page 25 of 54

QUANTITY

UNIT UNIT PRICE AMOUNT

0107 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 4 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0108 Mental Health Individual Counseling (6010)

120 Units Guaranteed Minimum; 1050 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

1,050 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0109 Mental Health Relationship and Parenting Counseling (6031)

1 Unit Guaranteed Minimum; 12 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0110 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 250 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

250 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0111 Sex Offender Intake Assessment & Report (5012)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS26Q00000001 Page 26 of 54

0112 Sex Offender Treatment Disorder Treatment Planning and Follow-up(6001)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0113 Sex Offender Intake Screening (6005)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0114 Sex Offender Individual Counseling (6012)

70 Units Guaranteed Minimum; 480 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

480 EA $________ $_________________

15BCTS26Q00000001 Page 27 of 54

Section 2 - Contract Clauses

A.1 ADDENDUM TO FAR 52.212-4, Terms and Conditions-Commercial Products and Commercial Services (Nov

2023) (DEVIATION NOV 2025)

The terms and conditions for the following clauses are hereby incorporated into this solicitation and resulting contract as an addendum to FAR clause 52.212-4.

Clauses By Reference

52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.acquisition.gov

Clause Title Fill-ins (if applicable)

52.203-3 Gratuities (Apr 1984)

52.203-6 Alt I Restrictions on Subcontractor Sales to the Government

(Jun 2020) - Alternate I (Nov 2021)

52.203-12 Limitation On Payments to Influence Certain Federal

Transactions (Jun 2020)

52.203-13 Contractor Code of Business Ethics and Conduct (Nov

2021)

52.204-13 (DEV) System for Award Management-Maintenance (Oct 2018)

(DEVIATION NOV 2025)

52.204-19 Incorporation by Reference of Representations and

Certifications (Dec 2014)

52.204-27 Prohibition on a ByteDance Covered Application (Jun

2023)

52.204-91 (DEV) Contractor Identification (DEVIATION NOV 2025)

52.209-6 (DEV) Protecting the Government's Interest When

Subcontracting with Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded (Jan

2025) (DEVIATION NOV 2025)

15BCTS26Q00000001 Page 28 of 54

Clause Title Fill-ins (if applicable)

52.212-4 (DEV) Terms and Conditions-Commercial Products and

Commercial Services (Nov 2023) (DEVIATION NOV

2025)

52.219-8 (DEV) Utilization of Small Business Concerns (Jan 2025)

(DEVIATION DEC 2025)

52.219-28 (DEV) Postaward Small Business Program Rerepresentation

(Jan 2025) (DEVIATION DEC 2025)

52.222-3 (DEV) Convict Labor (June 2003) (DEVIATION DEC 2025)

52.222-19 (DEV) Child Labor-Cooperation with Authorities and Remedies

(Jan 2025) (DEVIATION DEC 2025)

52.222-35 (DEV) Equal Opportunity for Veterans (Jun 2020) (DEVIATION

DEC 2025)

52.222-36 (DEV) Equal Opportunity for Workers with Disabilities (Jun

2020) (DEVIATION DEC 2025)

52.222-37 (DEV) Employment Reports on Veterans (Jun 2020)

(DEVIATION DEC 2025)

52.222-41 (DEV) Service Contract Labor Standards (Aug 2018)

(DEVIATION DEC 2025)

52.222-50 (DEV) Combating Trafficking in Persons (Oct 2025)

(DEVIATION DEC 2025)

52.222-54 (DEV) Employment Eligibility Verification (Jan 2025)

(DEVIATION DEC 2025)

52.224-1 Privacy Act Notification (Apr 1984)

52.224-3 Privacy Training (Jan 2017)

52.232-33 Payment by Electronic Funds Transfer-System for

Award Management (Oct 2018)

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors (Mar 2023)

52.233-3 (DEV) Protest after Award (Aug 1996) (DEVIATION NOV 2025)

52.233-4 (DEV) Applicable Law for Breach of Contract Claim (Oct 2004)

(DEVIATION NOV 2025)

15BCTS26Q00000001 Page 29 of 54

Clause Title Fill-ins (if applicable)

52.240-91 (DEV) Security Prohibitions and Exclusions (DEVIATION NOV

2025)

52.242-13 Bankruptcy (July 1995)

52.242-15 Stop-Work Order (Aug 1989)

52.252-6 Authorized Deviations in Clauses (Nov 2020)

52.253-1 (DEV) Computer Generated Forms (Jan 1991) (DEVIATION

NOV 2025)

Clauses By Full Text

52.209-9 (DEV) Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (DEVIATION

NOV 2025)

(a) The Contractor shall update the information in the Federal Awardee Performance and…

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