W912QG-22-R-0011 Pricing Summary Worksheet.pdf
PDF 192 KB Posted
- Attached to
- OSHA Surveillance Examinations Federal contract opportunity
- Solicitation number
- W912QG-22-R-0011
About this file
This is a request for proposal from the Department of the Army South Carolina Army National Guard seeking offers for occupational health examination services. The contractor shall provide all necessary personnel, equipment, materials and quality control to perform services including health exams, medical histories, laboratory tests, vision screening and reporting. The base period of performance is eight months with four one-year option periods. The solicitation is set aside 100% for small businesses with a size standard of $35 million. Proposals are due by March 21, 2022 and award is anticipated to be a single firm-fixed-price contract. Offerors must demonstrate relevant past performance and provide fixed pricing for the base year and all option periods using the attached pricing summary worksheet. Evaluation will consider past performance and total evaluated price including all options and a potential six-month extension.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Government Response to Offerors Questions 10 Mar 2022.pdf | ||
| W912QG-22-R-0011 Provision and Clauses.pdf | ||
| Past Performance Evaluation Questionnaire W912QG-22-R-0011.pdf | ||
| Approved PWS Annual OSHA Surveillance Exams.pdf |
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Text version
Pricing Summary Worksheet – Base Year (8 months) CLIN 0001
Item Requirement
Maximum # of Employees
Per Item
Cost Per Each
Total Item Cost 01 HW/BMI/BP 400ea $ $
02 Mailing Employee 400ea $ $
03 Respirator Fit Test 30ea $ $
04 Report OHN 400ea $ $
05 Lab (CMP, CBC) 400ea $ $
Pulmonary
Function Test 30ea $ $
Medical/Work
History 400ea $ $
08 Lead/ZPP 20ea $ $
09 Vision Screening 400ea $ $
Master Summery
Report 1ea $ $
Total Base Price = $
Pricing Summary Worksheet – Option Year 1 (12months) CLIN 1001
02 Mailing Employee 400ea $ $
03 Respirator Fit Test 30ea $ $
04 Report OHN 400ea $ $
05 Lab (CMP, CBC) 400ea $ $
Pulmonary
Function Test 30ea $ $
Medical/Work
History 400ea $ $
08 Lead/ZPP 20ea $ $
09 Vision Screening 400ea $ $
Master Summery
Total Option Year 1 Price = $
Pricing Summary Worksheet – Option Year 2 (12months) CLIN 2001
02 Mailing Employee 400ea $ $
03 Respirator Fit Test 30ea $ $
04 Report OHN 400ea $ $
05 Lab (CMP, CBC) 400ea $ $
Pulmonary
Function Test 30ea $ $
Medical/Work
History 400ea $ $
08 Lead/ZPP 20ea $ $
09 Vision Screening 400ea $ $
Master Summery
Total Option Year 2 Price = $
Pricing Summary Worksheet – Option Year 3 (12months) CLIN 3001
02 Mailing Employee 400ea $ $
03 Respirator Fit Test 30ea $ $
04 Report OHN 400ea $ $
05 Lab (CMP, CBC) 400ea $ $
Pulmonary
Function Test 30ea $ $
Medical/Work
History 400ea $ $
08 Lead/ZPP 20ea $ $
09 Vision Screening 400ea $ $
Master Summery
Total Option Year 3 Price = $
Pricing Summary Worksheet – Option Year 4 (12months) CLIN 4001
02 Mailing Employee 400ea $ $
03 Respirator Fit Test 30ea $ $
04 Report OHN 400ea $ $
05 Lab (CMP, CBC) 400ea $ $
Pulmonary
Function Test 30ea $ $
Medical/Work
History 400ea $ $
08 Lead/ZPP 20ea $ $
09 Vision Screening 400ea $ $
Master Summery
Total Option Year 4 Price = $
Total Overall Contract Price (including base year and 4 option years) $___________________________
IAW FAR Clause 52.217-8, the Government will evaluate a 6 month option price at 1/2 the price of CLIN 4001 total price. The period of performance for the 6 month option is 1 Jan 2027 – 29 Jun 2027. This option will only be exercised at the discretion of the Government and will occur at the very end of Option Year 4.
(End)
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