The file's text, extracted by GovTribe without its formatting.
B.2 SCHEDULE OF SUPPLIES AND SERVICES (PRICE)
Instructions to Offerors for completing Price Schedule:
(NOTE: Florida, Alabama, and Mississippi require Medicaid waivers therefore State Medicaid Adjustments are not applicable)
SCHEDULE OF PER DIEM RATES
BASE Period: 6/1/2018 to 5/31/2019
| CLIN |
| Description of Services |
| Price |
| 0001 |
| ELDER AND ADULT DAY HEALTH CARE (ADHC SERVICES IN ACCORDANCE WITH PERFORMANCE WORK STATEMENT) |
| Do Not Price |
| 0001AA |
| Full day (maximum of 9 hours) |
| $ |
| 0001AB |
| ½ day (maximum of 5 hours) |
| $ |
| 0002 |
| TRANSPORTATION |
| Do Not Price |
| 0002AA |
| Within 5 mile radius of facility – FLAT round trip rate |
| $ |
| 0002AB |
| Within 6 to 20 mile radius of facility-FLAT round trip rate |
| $ |
| 0002AC |
| Over 20 mile radius- round trip PER MILE rate |
| 0002AD |
| One-way transportation only |
Option one period: 6/1/2019 to 5/31/2020
| CLIN |
| Description of Services |
| Price |
| 1001 |
| ELDER AND ADULT DAY HEALTH CARE (ADHC SERVICES IN ACCORDANCE WITH PERFORMANCE WORK STATEMENT) |
| Do Not Price |
| 1001AA |
| Full day (maximum of 9 hours) |
| $ |
| 1001AB |
| ½ day (maximum of 5 hours) |
| $ |
| 1002 |
| TRANSPORTATION |
| Do Not Price |
| 1002AA |
| Within 5 mile radius of facility – FLAT round trip rate |
| $ |
| 1002AB |
| Within 6 to 20 mile radius of facility-FLAT round trip rate |
| $ |
| 1002AC |
| Over 20 mile radius- round trip PER MILE rate |
| 1002AD |
| One-way transportation only |
Option two period: 6/1/2020 to 5/31/2021
| CLIN |
| Description of Services |
| Price |
| 2001 |
| ELDER AND ADULT DAY HEALTH CARE (ADHC SERVICES IN ACCORDANCE WITH PERFORMANCE WORK STATEMENT) |
| Do Not Price |
| 2001AA |
| Full day (maximum of 9 hours) |
| $ |
| 2001AB |
| ½ day (maximum of 5 hours) |
| $ |
| 2002 |
| TRANSPORTATION |
| Do Not Price |
| 2002AA |
| Within 5 mile radius of facility – FLAT round trip rate |
| $ |
| 2002AB |
| Within 6 to 20 mile radius of facility-FLAT round trip rate |
| $ |
| 2002AC |
| Over 20 mile radius- round trip PER MILE rate |
| 2002AD |
| One-way transportation only |
Option three period: 6/1/2021 to 5/31/2022
| CLIN |
| Description of Services |
| Price |
| 3001 |
| ELDER AND ADULT DAY HEALTH CARE (ADHC SERVICES IN ACCORDANCE WITH PERFORMANCE WORK STATEMENT) |
| Do Not Price |
| 3001AA |
| Full day (maximum of 9 hours) |
| $ |
| 3001AB |
| ½ day (maximum of 5 hours) |
| $ |
| 3002 |
| TRANSPORTATION |
| Do Not Price |
| 3002AA |
| Within 5 mile radius of facility – FLAT round trip rate |
| $ |
| 3002AB |
| Within 6 to 20 mile radius of facility-FLAT round trip rate |
| $ |
| 3002AC |
| Over 20 mile radius- round trip PER MILE rate |
| 3002AD |
| One-way transportation only |
Option four period: 6/1/2022 to 5/31/2023
| CLIN |
| Description of Services |
| Price |
| 4001 |
| ELDER AND ADULT DAY HEALTH CARE (ADHC SERVICES IN ACCORDANCE WITH PERFORMANCE WORK STATEMENT) |
| Do Not Price |
| 4001AA |
| Full day (maximum of 9 hours) |
| $ |
| 4001AB |
| ½ day (maximum of 5 hours) |
| $ |
| 4002 |
| TRANSPORTATION |
| Do Not Price |
| 4002AA |
| Within 5 mile radius of facility – FLAT round trip rate |
| $ |
| 4002AB |
| Within 6 to 20 mile radius of facility-FLAT round trip rate |
| $ |
| 4002AC |
| Over 20 mile radius- round trip PER MILE rate |
| 4002AD |
| One-way transportation only |
NOTE: for purposes of price evaluation an estimated quantity of 15 Veterans will be used.
NOTE: The specified rates for use if FAR Clause 52.217-8 is exercised by the Government will be those rates in effect under the Basic Ordering Agreement/Contract preceding this option (Refer to Section E FAR 52.212-2 in regards to the evaluation of this option.)
END OF PRICE SCHEDULE
