Solicitation 15BCTS21Q00000027 Topeka KS.pdf
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15BCTS21Q00000027 Page 1 of 68
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER
5. SOLICITATION NUMBER
15BCTS21Q00000027
2. CONTRACT NO. 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
04/27/2021
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Kathaleen Cannon kacannon@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-305-9853
8. OFFER DUE DATE / LOCAL
TIME
05/17/2021 14:00
CODE BCTS
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534
9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR
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: 621420
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
15B400CODE15. DELIVER TO
Federal Bureau of Prisons Kansas City Office
400 STATE AVENUE
SUITE 800
KANSAS CITY, KS 66101
CODE BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534
Kathaleen Cannon
(O) 202-305-9853 kacannon@bop.gov
FACILITY
CODE
CODE
TELEPHONE NO.
17a. CONTRACTOR/
OFFEROR
15B400CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Kansas City Office
400 STATE AVENUE
SUITE 800
KANSAS CITY, KS 66101
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 Topeka, KS
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 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)
Kathaleen Cannon
31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 2/2012)
Prescribed by GSA - FAR (48 CFR) 53.212
X
07/01/2021
0027-21
15BCTS21Q00000027 Page 2 of 70
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
15BCTS21Q00000027 Page 3 of 70
Table of Contents
Section Description Page Number
1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses
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 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 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) 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)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR
2011)
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) 52.212-3 Offeror Representations and Certifications-Commercial Items (Feb 2021) 52.216-1 Type of Contract (Apr 1984)
15BCTS21Q00000027 Page 4 of 70
Section 2 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 24 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,152 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 24 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,728 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT
15BCTS21Q00000027 Page 5 of 70
UNIT PRICE AMOUNT
0006 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 24 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
576 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
840 EA $________ $_________________
15BCTS21Q00000027 Page 6 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
10 EA $________ $_________________
15BCTS21Q00000027 Page 7 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Mental Health Intake Assessment & Report (5011) (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
0019 Psychiatric Evaluation & Report (5030) (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
0020 Crisis Intervention (6000) Estimated 1 Unit per Inmate; 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
0021 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 48 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
528 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 11 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
528 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
UNIT UNIT PRICE AMOUNT
0023 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 11 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
264 EA
15BCTS21Q00000027 Page 8 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 11 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
264 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Administration of Medication (6050) (6 visits per inmate) for Estimated 11 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
66 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Medication Monitoring and Report (6051) (five per inmate) for Estimated 11 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
55 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Sex Offense Specific Intake Assessment & Report (5012) (one per inmate) for Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Sex Offender Intake Screening (6005) (30 Minutes = 1 Unit) Estimated 1 Unit per Inmate; Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
5 EA $________ $_________________
UNIT
15BCTS21Q00000027 Page 9 of 70
UNIT PRICE AMOUNT
0029 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate Estimated 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
240 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 5 Inmates
Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Sex Offender Family Counseling (6032) (30 minutes = 1 unit) Estimated 24 units per inmate for Estimated 5 Inmates
Base Year: 1 month through 12 months
Firm Fixed Price
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
960 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
20 SS $________ $_________________
15BCTS21Q00000027 Page 10 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
1,440 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
15BCTS21Q00000027 Page 11 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 1: 13 months through 24 months
30 EA $________ $_________________
15BCTS21Q00000027 Page 12 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Mental Health Intake (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 Mental Health Intake Assessment & Report (5011) (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
0050 Psychiatric Evaluation & Report (5030) (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
0051 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
0052 Mental Health Individual Counseling (6010) 480 EA $________ $_________________
15BCTS21Q00000027 Page 13 of 70
(30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
50 EA $________ $_________________
UNIT
15BCTS21Q00000027 Page 14 of 70
UNIT PRICE AMOUNT
0058 Sex Offender Specific Intake Assessment & Report (5012) (one per inmate) for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Sex Offender Intake Screening (6005) (30 Minutes = 1 Unit) Estimated 1 Unit per Inmate; Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
5 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 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
240 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 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Sex Offender Family Counseling (6032) (30 minutes = 1 unit) Estimated 24 units per inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
Firm Fixed Price
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
20 EA $________ $_________________
15BCTS21Q00000027 Page 15 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
960 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
1,440 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
15BCTS21Q00000027 Page 16 of 70
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
0075 MAT - Buprenorphine and Administration of Injection (4031)
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA
15BCTS21Q00000027 Page 17 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Mental Health Intake (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 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
UNIT
15BCTS21Q00000027 Page 18 of 70
UNIT PRICE AMOUNT
0081 Psychiatric Evaluation & Report (5030) (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
0082 Crisis Intervention (6000) Estimated 1 Unit per Inmate; 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
0083 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
240 EA $________ $_________________
15BCTS21Q00000027 Page 19 of 70
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Sex Offender Specific Intake Assessment & Report (5012) (one per inmate) for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Sex Offender Intake Screening (6005) (30 Minutes = 1 Unit) Estimated 1 Unit per Inmate; Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
5 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 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
0092 Sex Offender Group Counseling (6022) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
360 EA
15BCTS21Q00000027 Page 20 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Sex Offender Family Counseling (6032) (30 minutes = 1 unit) Estimated 24 units per inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
Firm Fixed Price
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
960 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
20 SS $________ $_________________
UNIT
15BCTS21Q00000027 Page 21 of 70
UNIT PRICE AMOUNT
0098 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
1,440 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
15BCTS21Q00000027 Page 22 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
15BCTS21Q00000027 Page 23 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Mental Health Intake (5005) (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
0111 Mental Health Intake Assessment & Report (5011) (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
0112 Psychiatric Evaluation & Report (5030) (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
0113 Crisis Intervention (6000) Estimated 1 Unit per Inmate; 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
0114 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
0115 Mental Health Group Counseling (6020) 480 EA $________ $_________________
15BCTS21Q00000027 Page 24 of 70
(30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 Sex Offender Specific Intake Assessment & Report (5012) (one per inmate) for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
UNIT
15BCTS21Q00000027 Page 25 of 70
UNIT PRICE AMOUNT
0121 Sex Offender Intake Screening (6005) (30 Minutes = 1 Unit) Estimated 1 Unit per Inmate; Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0122 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
240 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 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0124 Sex Offender Family Counseling (6032) (30 minutes = 1 unit) Estimated 24 units per inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
Firm Fixed Price
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
960 SS $________ $_________________
15BCTS21Q00000027 Page 26 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0127 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0128 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
20 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0129 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
1,440 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0130 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0131 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0132 MAT - Naltrexone Follow-Up and Report (4003)
15BCTS21Q00000027 Page 27 of 70
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0133 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0134 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0135 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0136 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0137 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
0138 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA
15BCTS21Q00000027 Page 28 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0139 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0140 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0141 Mental Health Intake (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 Mental Health Intake Assessment & Report (5011) (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
0143 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
UNIT
15BCTS21Q00000027 Page 29 of 70
UNIT PRICE AMOUNT
0144 Crisis Intervention (6000) Estimated 1 Unit per Inmate; 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
0145 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0146 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0147 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0148 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0149 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
60 EA $________ $_________________
15BCTS21Q00000027 Page 30 of 70
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0150 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0151 Sex Offender Specific Intake Assessment & Report (5012) (one per inmate) for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0152 Sex Offender Intake Screening (6005) (30 Minutes = 1 Unit) Estimated 1 Unit per Inmate; Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
5 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 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
240 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 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
0155 Sex Offender Family Counseling (6032) (30 minutes = 1 unit) Estimated 24 units per inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
Firm Fixed Price
PSC: G004
120 EA
15BCTS21Q00000027 Page 31 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0156 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0157 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
480 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0158 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
10 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0159 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
10 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0160 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
720 EA $________ $_________________
UNIT
15BCTS21Q00000027 Page 32 of 70
UNIT PRICE AMOUNT
0161 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0162 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0163 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0164 MAT - Administration of Methadone (4010) Estimated 168 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
504 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0165 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
504 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0166 MAT – Buprenorphine and Administration (4021) Estimated 168 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
504 EA $________ $_________________
15BCTS21Q00000027 Page 33 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0167 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0168 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0169 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 3 Inmates
Potential 6 Month Extension
Firm Fixed Price
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE…
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