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U. S. Department of Justice
Federal Bureau of Prisons
Washington, D.C. 20534
January 29, 2021
Re: 15BCTS21Q00000038, Fort Myers, FL
All Interested Parties:
This Request for Quotation (RFQ) is to provide Mental Health, Substance Use, Sex Offender and Medication Assisted Treatment Services for male and female offenders held under authority of the United States in Fort Myers, FL. Services are to be provided in accordance with the enclosed Statement of Work entitled, “Federal Bureau of Prisons, Community Treatment Services, Statement of Work, October 2020.”
The following must be completed and submitted with your Quotation:
Standard Form (SF) 1449 - Solicitation/Contract/Order for Commercial Items - Please complete blocks 12, 17a, 17b, 23, 24, 30a, 30b, and 30c of the SF-1449 and the continuation sheets.
Please include your telephone number in Block 17a. Original signatures are required.
Quoter Representations and Certifications (FAR 52.212-3) - Prospective quoters are required to submit Annual Representations and Certifications at https://www.sam.gov/portal/public/SAM/. By submission of a quote under this solicitation, the quoter acknowledges completion of the annual representations and certifications via SAM and verifies, by the submission of the quote, that the representations and certifications currently posted in SAM were entered or updated within the last 12 months and are current, accurate, complete and applicable to this solicitation. All quoters must be capable of and comply with FAR 52.212-1(j), Instructions to Offerors - Commercial Items, Unique Entity Identifier (Jun 2020) and FAR 52.204-7, System of Award Management(SAM) (Oct 2018).
Required Documentation Identified at Addendum to FAR 52.212-1, Instructions to Offerors - Commercial Items Government shall award to the lowest price, technically acceptable, responsive and responsible quoter.
Electronic copies of quotations shall be submitted by email in Adobe Acrobat (PDF) format only. Email attachments (PDFs only) cannot total more than 14 MB per email. Please compress PDFs when possible to reduce the file size. We understand you will likely need to send multiple emails. Please include SEPARATE FILE ATTACHMENTS for the following:
Completed SF-1449 (including the pricing table at Section 2.1) Completed Business Quotation Information sheet Completed Technical Quotation Information packet Proof of completed SAM registration (must be Active by time of quotation submission) A copy of your current Professional Liability Insurance
Quotations shall be emailed by February 22, 2021, 12:00 P.M. EST to smutts@bop.gov. Please confirm that all emails and attachments were received.
The solicitation will be distributed solely through the General Services Administration’s Beta SAM.gov website (beta.sam.gov).
Hard copies of the solicitation document will not be available. The website provides downloading instructions. All future information about this solicitation, including solicitation amendments, will be solely distributed through this website. Interested parties are responsible for monitoring this website to ensure they have the most up-to-date information about this solicitation.
Please direct any questions to smutts@bop.gov.
Sincerely, Shannon Mutts Contracting Officer
15BCTS21Q00000038 Page 1 of 84
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER
5. SOLICITATION NUMBER
15BCTS21Q00000038
2. CONTRACT NO. 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
01/29/2021
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Shannon Mutts, smutts@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-305-9973
8. OFFER DUE DATE / LOCAL
TIME
02/22/2021 12:00 ET
CODE 15BCTS
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contracting 320 First Street NW Suite 5005 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
WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM
EDWOSB
8(A)
NAICS:
SIZE STANDARD: $16,500,000
10. THE ACQUISITION IS
SEE
SCHEDULE
11. DELIVERY FOR FOB DESTINATION
UNLESS BLOCK IS MARKED
12. DISCOUNT TERMS
13a. THIS CONTRACT IS A
RATED ORDER UNDER DPAS
(15 CFR 700)
13b. RATING
X RFQ IFB RFP
14. METHOD OF SOLICITATION
15B300CODE15. DELIVER TO
Federal Bureau of Prisons Atlanta Field Office Community Treatment Services (CTS) 719 McDonough Blvd, SE Atlanta, GA 30315
CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contracting 320 First Street NW Suite 5005 Washington, DC 20534
Shannon Mutts
(O) 202-305-9973 smutts@bop.gov
FACILITY
CODE
CODE
TELEPHONE NO.
17a. CONTRACTOR/
OFFEROR
15B300CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Atlanta Field Office Community Treatment Services (CTS) 719 McDonough Blvd, SE Atlanta, GA 30315
BOP-RSD-PSBCTS-BILL@BOP.GOV
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 NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
Substance Use, Mental Health, Sex Offender and Medication Assisted Treatment Services in Fort Myers, FL
See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)
X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE 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: REF. _____________________________ 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)
Shannon Mutts
31c. DATE SIGNED
01/29/2021
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 2/2012)
Prescribed by GSA - FAR (48 CFR) 53.212
038-21
621420
15BCTS21Q00000038 Page 2 of 84
19.
ITEM NO.
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. 2/2012) BACK
15BCTS21Q00000038 Page 3 of 84
Table of Contents
Section Description Page Number
1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses
52.21-603-70 Contracting Officer's Representative (COR) (June 2012)
52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE
2004)
52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA
OR OTHER NATIONAL EMERGENCY (May 2008) DJAR-PGD-15-03 Security of Department Information and Systems 52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.216-21 Requirements (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.232-18 Availability of Funds (Apr 1984) 52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR
2011) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items (Jan 2021)
4 List of Attachments 5 Solicitation Provisions
52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.213-3 Offeror Representations and Certifications- Commercial Items (Jan 2021) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998) 52.216-1 Type of Contract (Apr 1984) 52.217-5 Evaluation of Options (July 1990)
15BCTS21Q00000038 Page 4 of 84
Section 2 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Intake - Substance Use (2005) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 46 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2,208 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 24 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
24 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 8 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
8 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 46 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
3,312 EA $________ $_________________
15BCTS21Q00000038 Page 5 of 84
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 4 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 4 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Administration of Buprenorphine Injection - MAT (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
12 EA $________ $_________________
15BCTS21Q00000038 Page 6 of 84
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Buprenorphine and Administration of Injection MAT (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Buprenorphine Implant and Removal MAT (4032) Estimated 1 Units per Inmate for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 4 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 4 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 6 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Psychiatric Evaluation & Intake - Mental Health (5005) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
10 EA $________ $_________________
15BCTS21Q00000038 Page 7 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 21 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,008 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Case Management Services (6030) Estimated 3 Units per Inmate; Estimated 6 Inmates
18 EA $________ $_________________
15BCTS21Q00000038 Page 8 of 84
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 3 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
9 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 21 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
126 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 21 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
105 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
15BCTS21Q00000038 Page 9 of 84
0029 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
96 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 2 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Intake - Substance Use (2005) (one per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 32 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
1,536 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 24 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
24 SS $________ $_________________
15BCTS21Q00000038 Page 10 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 8 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
8 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 32 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 4 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
336 EA $________ $_________________
15BCTS21Q00000038 Page 11 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Administration of Buprenorphine Injection - MAT (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Buprenorphine and Administration of Injection MAT (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Buprenorphine Implant and Removal MAT (4032) Estimated 1 Units per Inmate for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 4 Inmates
24 EA $________ $_________________
15BCTS21Q00000038 Page 12 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 6 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Psychiatric Evaluation & Intake - Mental Health (5005) (one per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
720 EA $________ $_________________
15BCTS21Q00000038 Page 13 of 84
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Case Management Services (6030) Estimated 3 Units per Inmate; Estimated 6 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 3 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
9 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000038 Page 14 of 84
0058 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
96 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 2 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Intake - Substance Use (2005) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
15BCTS21Q00000038 Page 15 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 32 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
1,536 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 24 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
24 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 8 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
8 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 32 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 4 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
15BCTS21Q00000038 Page 16 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Administration of Buprenorphine Injection - MAT (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Buprenorphine and Administration of Injection MAT (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Buprenorphine Implant and Removal MAT (4032) Estimated 1 Units per Inmate for Estimated 2 Inmates
2 EA $________ $_________________
15BCTS21Q00000038 Page 17 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 4 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 6 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Psychiatric Evaluation & Intake - Mental Health (5005) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates
15 EA $________ $_________________
15BCTS21Q00000038 Page 18 of 84
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Case Management Services (6030) Estimated 3 Units per Inmate; Estimated 6 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 3 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
9 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000038 Page 19 of 84
0087 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
96 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
144 EA $________ $_________________
15BCTS21Q00000038 Page 20 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 2 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Intake - Substance Use (2005) (one per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 32 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
1,536 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 24 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
24 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 8 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
8 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 32 Inmates
Option Year 3: 37 months through 48 months
2,304 EA $________ $_________________
15BCTS21Q00000038 Page 21 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 4 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 Administration of Buprenorphine Injection - MAT (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates
15BCTS21Q00000038 Page 22 of 84
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 Buprenorphine and Administration of Injection MAT (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 Buprenorphine Implant and Removal MAT (4032) Estimated 1 Units per Inmate for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 4 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 6 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Psychiatric Evaluation & Intake - Mental Health (5005) (one per inmate) for Estimated 10 Inmates
15BCTS21Q00000038 Page 23 of 84
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000038 Page 24 of 84
0116 Case Management Services (6030) Estimated 3 Units per Inmate; Estimated 6 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 3 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
9 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0121 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
15BCTS21Q00000038 Page 25 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0122 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
96 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0123 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0124 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 2 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Intake - Substance Use (2005) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 32 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
1,536 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0127 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 24 Inmates
Option Year 4: 49 months through 60 months
24 SS $________ $_________________
15BCTS21Q00000038 Page 26 of 84
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0128 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 8 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
8 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0129 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 32 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0130 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 4 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0131 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0132 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000038 Page 27 of 84
0133 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0134 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0135 Administration of Buprenorphine Injection - MAT (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0136 Buprenorphine and Administration of Injection MAT (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0137 Buprenorphine Implant and Removal MAT (4032) Estimated 1 Units per Inmate for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0138 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 4 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
24 EA $________ $_________________
15BCTS21Q00000038 Page 28 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0139 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 4 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0140 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 6 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0141 Psychiatric Evaluation & Intake - Mental Health (5005) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0142 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0143 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0144 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
15BCTS21Q00000038 Page 29 of 84
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0145 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0146 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0147 Case Management Services (6030) Estimated 3 Units per Inmate; Estimated 6 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0148 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 3 Units per Inmate; Estimated 3 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
9 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0149 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0150 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates
75 EA $________ $_________________
15BCTS21Q00000038 Page 30 of 84
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0151 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0152 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0153 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 2 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
96 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0154 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 2 Inmates
Option Year 4: 49 months…
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