Solicitation No. 15BCTS22Q00000013 - Oakland, CA.pdf

U. S. Department of Justice

Federal Bureau of Prisons

Washington, D.C. 20534

December 6, 2021

Re: 15BCTS22Q00000013, Oakland, CA

All Interested Parties:

This Request for Quotation (RFQ) is to provide Substance Abuse and Mental Health Treatment services for male and female offenders held under authority of the United States in Oakland, CA. 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 (SEP 2021) 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 Tuesday, January 4, 2021 12:00 P.M. EST to cmagee@bop.gov. Please confirm that all emails and attachments were received.

The solicitation will be distributed solely through the General Services Administration’s SAM.gov website (sam.gov).A 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 cmagee@bop.gov.

Sincerely, Coretta MaGee Contracting Officer

CORETTA

MAGEE

Digitally signed by

CORETTA MAGEE

Date: 2021.12.06 13:22:45 -05'00'

15BCTS22Q00000013 Page 1 of 70

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30

1. REQUISITION NUMBER PAGE 1 OF 70

5. SOLICITATION NUMBER

15BCTS22Q00000013

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

12/06/2021

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Coretta MaGee cmagee@bop.gov

b. TELEPHONE NUMBER (No collect calls)

202-616-1293

8. OFFER DUE DATE / LOCAL

TIME

01/04/2022 12:00 ET

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 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: 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

BWROCODE15. DELIVER TO

Federal Bureau of Prisons Western Region - TDAT Office TDAT Office 1299 Seaside Avenue San Pedro, CA 90731

CODE BCTS16. ADMINISTERED BY

Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534

Coretta MaGee

(O) 202-616-1293 cmagee@bop.gov

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

BWROCODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons Western Region - TDAT Office TDAT Office 1299 Seaside Avenue San Pedro, CA 90731

BOP-RSD-CRBCTS-BILL-LA@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, Medication Assisted Treatment and Mental Health Treatment Services in Oakland, CA Firm Fixed Price

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

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

Coretta MaGee

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

013-22

15BCTS22Q00000013 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

15BCTS22Q00000013 Page 3 of 70

Table of Contents

Section Description Page Number

1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses

52.242-15 Stop-Work Order (Aug 1989) 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 52.203-3 Gratuities (Apr 1984) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.204-12 Unique Entity Identifier Maintenance (Oct 2016) 52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Dec 2013) 52.242-13 Bankruptcy (July 1995) 52.253-1 Computer Generated Forms (Jan 1991) 52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights (Jun 2020) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items (Sep 2021) 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) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.223-99 DEV Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors (Oct 2021)

(DEVIATION)

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) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021); (Alt. I) -- Classified Information -- Cleared Contractors

4 List of Attachments 5 Solicitation Provisions

52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) 52.212-3 Offeror Representations and Certifications-Commercial Items (Feb 2021) 52.216-1 Type of Contract (Apr 1984)

15BCTS22Q00000013 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 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0002 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 90 Inmates

Base Period: Date of award - 12 months

PSC: G004

2,160 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0003 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 90 Inmates

Base Period: Date of award - 12 months

PSC: G004

90 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0004 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

10 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0005 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 90 Inmates

Base Period: Date of award - 12 months

PSC: G004

3,240 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0006 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

Base Period: Date of award - 12 months

PSC: G004

20 EA $________ $_________________

15BCTS22Q00000013 Page 5 of 70

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

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

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0009 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 3 Inmates

Base Period: Date of award - 12 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0010 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 3 Inmates

Base Period: Date of award - 12 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0011 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates

Base Period: Date of award - 12 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0012 MAT - Buprenorphine and Administration of Injection(4031) Estimated 6 Units per Inmate for Estimated 2 Inmates

Base Period: Date of award - 12 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0013 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates

Base Period: Date of award - 12 months

30 EA $________ $_________________

15BCTS22Q00000013 Page 6 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0014 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates

Base Period: Date of award - 12 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0015 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0016 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0017 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 20 Inmates

Base Period: Date of award - 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0018 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 15 Inmates

Base Period: Date of award - 12 months

PSC: G004

15 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0019 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 3 Inmates

Base Period: Date of award - 12 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

15BCTS22Q00000013 Page 7 of 70

0020 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 20 Inmates

Base Period: Date of award - 12 months

PSC: G004

200 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0021 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

320 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0022 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

Base Period: Date of award - 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0023 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates

Base Period: Date of award - 12 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0024 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates

Base Period: Date of award - 12 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0025 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0026 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 75 Inmates

Option Year 1: 13 months through 24 months

1,800 SS $________ $_________________

15BCTS22Q00000013 Page 8 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0027 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 75 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

75 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0028 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

10 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0029 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 75 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

2,700 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0030 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

40 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0031 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0032 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0033 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 3 Inmates

18 EA $________ $_________________

15BCTS22Q00000013 Page 9 of 70

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0034 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0035 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0036 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0037 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0038 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0039 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 10 of 70

0040 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0041 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 20 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0042 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 15 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

15 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0043 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 3 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0044 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 20 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

200 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0045 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

320 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0046 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

15BCTS22Q00000013 Page 11 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0047 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0048 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates

Option Year 1: 13 months through 24 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0049 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0050 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 75 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

1,800 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0051 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 75 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

75 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0052 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

10 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0053 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 75 Inmates

2,700 EA $________ $_________________

15BCTS22Q00000013 Page 12 of 70

Option Year 2: 25 months through 36 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0054 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

40 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0055 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0056 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0057 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0058 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0059 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 13 of 70

0060 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0061 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0062 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0063 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0064 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0065 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 20 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0066 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 15 Inmates

Option Year 2: 25 months through 36 months

15 EA $________ $_________________

15BCTS22Q00000013 Page 14 of 70

QUANTITY

UNIT UNIT PRICE AMOUNT

0067 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 3 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0068 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 20 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

200 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0069 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

320 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0070 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0071 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0072 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates

Option Year 2: 25 months through 36 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 15 of 70

0073 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0074 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 75 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

1,800 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0075 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 75 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

75 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0076 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

10 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0077 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 75 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

2,700 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0078 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

40 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0079 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 3: 37 months through 48 months

15BCTS22Q00000013 Page 16 of 70

QUANTITY

UNIT UNIT PRICE AMOUNT

0080 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0081 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0082 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0083 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0084 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0085 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0086 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 3: 37 months through 48 months

15BCTS22Q00000013 Page 17 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0087 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0088 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0089 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 20 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0090 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 15 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

15 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0091 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 3 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0092 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 20 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

200 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 18 of 70

0093 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

320 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0094 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0095 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0096 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates

Option Year 3: 37 months through 48 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0097 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0098 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 75 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

1,800 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0099 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 75 Inmates

Option Year 4: 49 months through 60 months

75 SS $________ $_________________

15BCTS22Q00000013 Page 19 of 70

QUANTITY

UNIT UNIT PRICE AMOUNT

0100 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

10 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0101 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 75 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

2,700 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0102 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

40 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0103 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0104 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0105 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0106 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 3 Inmates

Option Year 4: 49 months through 60 months

18 EA $________ $_________________

15BCTS22Q00000013 Page 20 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0107 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0108 MAT - Buprenorphine and Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 2 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0109 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0110 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

30 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0111 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0112 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 21 of 70

0113 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 20 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0114 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 15 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

15 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0115 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 3 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0116 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 20 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

200 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0117 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

320 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0118 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0119 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates

Option Year 4: 49 months through 60 months

15BCTS22Q00000013 Page 22 of 70

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0120 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates

Option Year 4: 49 months through 60 months

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0121 Substance Use Intake Screening (2005) (one per inmate) for Estimated 5 Inmates

Potential 6 Month Extension

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0122 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 38 Inmates

Potential 6 Month Extension

PSC: G004

912 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0123 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 38 Inmates

Potential 6 Month Extension

PSC: G004

38 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0124 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 5 Inmates

Potential 6 Month Extension

PSC: G004

5 SS $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0125 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 36 Units per Inmate; Estimated 38 Inmates

Potential 6 Month Extension

PSC: G004

1,368 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0126 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 4 Units per Inmate; Estimated 5 Inmates

15BCTS22Q00000013 Page 23 of 70

Potential 6 Month Extension

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0127 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0128 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0129 MAT - Administration of Buprenorphine (4020) Estimated 6 Units per Inmate for Estimated 2 Inmates

Potential 6 Month Extension

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0130 MAT – Buprenorphine and Administration (4021) Estimated 6 Units per Inmate for Estimated 2 Inmates

Potential 6 Month Extension

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0131 MAT - Administration of Buprenorphine Injection (4030) Estimated 6 Units per Inmate for Estimated 1 Inmates

Potential 6 Month Extension

PSC: G004

6 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0132 Administration of Injection (4031) Estimated 6 Units per Inmate for Estimated 1 Inmates

Potential 6 Month Extension

PSC: G004

6 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS22Q00000013 Page 24 of 70

0133 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0134 MAT – Naltrexone and Administration (4041) Estimated 6 Units per Inmate; Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0135 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates

Potential 6 Month Extension

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0136 Mental Health Intake (5005) (one per inmate) for Estimated 5 Inmates

Potential 6 Month Extension

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0137 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates

Potential 6 Month Extension

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0138 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 8 Inmates

Potential 6 Month Extension

PSC: G004

8 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0139 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 2 Inmates

Potential 6 Month Extension

2 EA $________ $_________________

15BCTS22Q00000013 Page 25 of 70

QUANTITY

UNIT UNIT PRICE AMOUNT

0140 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 10 Units per Inmate; Estimated 10 Inmates

Potential 6 Month Extension

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0141 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 32 Units per Inmate; Estimated 5 Inmates

Potential 6 Month Extension

PSC: G004

160 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0142 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 4 Units per Inmate; Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

12 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0143 Administration of Medication (6050) (6 visits per inmate) for Estimated 3 Inmates

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0144 Medication Monitoring and Report (6051) (five per inmate) for Estimated 5 Inmates

Potential 6 Month Extension

25 EA $________ $_________________

15BCTS22Q00000013 Page 26 of 70

Section 3 - Contract Clauses

A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions-Commercial Items (Oct 2018)

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

Clauses By Reference

52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

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

Clause Title Fill-ins (if applicable)

52.242-15 Stop-Work Order (Aug 1989)

52.203-3 Gratuities (Apr 1984)

52.203-12 Limitation On Payments to Influence Certain Federal Transactions

(Jun 2020)

52.204-12 Unique Entity Identifier Maintenance (Oct 2016)

52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018)

52.224-1 Privacy Act Notification (Apr 1984)

52.224-2 Privacy Act (Apr 1984)

52.232-40 Providing Accelerated Payments to Small Business Subcontractors

(Dec 2013)

52.242-13 Bankruptcy (July 1995)

52.253-1 Computer Generated Forms (Jan 1991)

Clauses By Full Text

52.21-603-70 Contracting Officer's Representative (COR) (June 2012)

(a)Tiffany Olivi Lead COR (SCTC), Shannon Hart, (CTC), Shalini Haylock (CTOS), Daniel Reeser (CTOS), Miriam Guzman (CTOS) & Fidencio Lamas (CTOS) ) ,Los Angeles Field Office , 1299 Seaside Avenue, San Pedro, CA 90731,(9310-732-5185, 15BCTS22Q00000013 Page 27 of 70

215-521-7474, 310-732-5191, 310-732-5138, is hereby designated as the Contracting Officer's Representative (COR) under this contract.

(b) The COR is responsible, as applicable, for: receiving all deliverables, inspecting and accepting the supplies or services provide hereunder in accordance with the terms and conditions of this contract; providing direction to the contractor which clarifies the contractor effort, fills in details or otherwise serves to accomplish the contractual Scope of Work; evaluating performance; and certifying all invoices/vouchers for acceptance of the supplies or services furnished for payment.

(c) The COR does not have the authority to alter the contractor's obligations under the contract, and/or modify any of the expressed terms, conditions, specifications, or cost of the agreement. If as a result of technical discussions it is desirable to alter/change contractual obligations or the Scope of Work, the Contracting Officer shall issue such changes.

52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE 2004) (DEVIATION)

For three of the five years immediately prior to submission of an offer/bid/quote, or prior to performance under a contract or commitment, individuals or contractor employees providing services must have:

1. Legally resided in the United States (U.S.);

2. worked for the U.S. overseas in a Federal or military capacity; or

3. been a dependent of a Federal or military employee serving overseas.

If the individual is not a U.S. citizen, they must be from a country allied with the U.S. The following website provides current information regarding allied countries: http://www.state.gov/s/l/treaty/collectivedefense By signing this contract or commitment document, or by commencing performance, the contractor agrees to this restriction.

[End of Clause]

52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA OR OTHER NATIONAL EMERGENCY (May 2008)

During a Pandemic or other emergency we understand that our contractor workforce will experience the same high levels of absenteeism as our federal employees. Although the Excusable Delays and Termination for Default clauses used in Government contracts list epidemics and quarantine restrictions among the reasons to excuse delays in contract performance, we expect our contractors to make a reasonable effort to keep performance at an acceptable level during emergency periods.

The Office of Personnel Management (OPM) has provided guidance to federal managers and employees on the kinds of actions to be taken to ensure the continuity of operations during emergency periods. This guidance is also applicable to our contract workforce.

Contractors are expected to have reasonable policies in place for continuing work performance, particularly those performing mission critical services, during a pandemic influenza or other emergency situation.

The types of actions a federal contractor should reasonably take to help ensure performance are:

* Encourage employees to get inoculations…