Pricing Sheet Rev 1.pdf

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Occupational Health Medical Surveillance Exams
Solicitation number
W9124V25QA016
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This document is a Quote Sheet for Montana Occupational Health Medical Exams, Solicitation Number W9124V25QA016. The solicitation is for a Firm-Fixed Price contract to be awarded based on best value to the government, considering price, past performance, and technical capabilities. Potential contractors must price five different baseline medical exam types: Surface Maintenance, Aircraft Maintenance, Allied Trades, Electronics, and Audiogram Only.

The quote sheet includes a detailed matrix specifying required medical tests for each baseline exam type. Common tests across all baseline exams include physical exam, complete blood count, comprehensive metabolic panel, urinalysis, blood lead, blood zinc protoporphyrin, spirometry, chest x-ray, audiogram, and vision screening. Some specialized tests like blood cadmium/chromium and urine cadmium are specific to certain exam types, particularly Aircraft Maintenance and Electronics Baseline exams. To be considered responsive, contractors must complete the pricing table with both individual test pricing and total exam type pricing.

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SOLICITATION: W9124V25QA016

QUOTE SHEET

MONTANA OCCUPATIONAL HEALTH MEDICAL EXAMS

1. A Firm-Fixed Price contract will be awarded for this requirement on the best value to the government in accordance with price, past performance, and technical capabilities.

2. In order for the contractor’s quote to be considered “Responsive”, the items below must be priced. If not, the price quote will be deemed non-Responsive and not considered for technical review or award. Use the table on page 2 to determine test components for each type of baseline. The contractor shall include the total for each exam type as well as individual test pricing on the table on page 2.

Organization Name:

CAGE/UEI Number:

Contact Name:

Contact Phone Number:

Contact Email:

DESCRIPTION UNIT OF MEASURE UNIT PRICE

Surface Maintenance Baseline Exam

JOB

Aircraft Maintenance Baseline Exam

JOB

Allied Trades Baseline Exam

JOB

Electronics Baseline Exam JOB

Audiogram Only JOB

Unit Price

Surface Maintenance Baseline

Aircraft Maintenance Baseline

Allied Trades Baseline

Electronics Baseline

Audiogram

Physical Exam X X X X

Complete Blood Count w/Diff

X X X X

Comprehensive Metabolic Panel

X X X X

Urinalysis X X X X

Blood Lead X X X X

Blood Zinc Protoporphyrin

X X X X

Blood Cadmium and Chromium

X X

Urine cadmium X X

Urine Beta 2 Microgloblin

X X

Spirometry (respiratory user Only)

X X X X

Chest Xray, 2 View

X X X X

Audiogram X X X X X

Vision: Near, distant, color, depth perception, field of vision

X X X X

File details come from the government source that posted it. Updated .