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Sample Bid in response to

Department of Corrections

RFQQ10xxxx

1. DEFINITIONS FOR THE PURPOSES OF THIS BID INCLUDE:

Bid – A formal offer submitted in response to this solicitation.

Bidder – Individual or company submitting a response in order to attain a contract with the DEPARTMENT.

Contractor – Individual or company whose bid has been accepted by the DEPARTMENT and is awarded a fully executed, written contract.

Department or DOC – The Department of Corrections is the agency of the state of Washington that is issuing this RFQQ.

1.2 PERIOD OF PERFORMANCE

The period of performance of any contract resulting from this RFQQ is scheduled to commence upon February 1, 2016, and continue through January 31, 2018, unless sooner terminated as provided in the contract. Both parties may agree to a maximum of two 2- year extensions by written amendment to this contract. Either party may terminate this Agreement sooner as provided within the Agreement.

Letter of Submittal

2.1 Bidder Qualifications

Employs Denturist(s) who are licensed to practice in the state of Washington.

Licensed to do business in the state of Washington prior to the start of the contract term.

Are able to bill and be paid electronically through the Washington State Health Care Authority’s Provider One system.

Able to comply with the Department’s requirement to be enrolled in the National Practitioner Data Bank.

2.2 License History

Became a Licensed Denturist Fall 2004.

2.3 Professional Membership’s

o Member of the Washington Denturist Association:

§ Served on the board for 6 years and

§ Currently Vice President for the last 3 years.

o Member of the National Denturist Association.

o Member of the International Federation of Denturists.

o Clinical and Laboratory mentoring with the students at Bates Technical College in Tacoma with Dr. Xxxx.

o Opened Columbia Basin Denture Care, PLLC in 2004 in Kennewick Washington. Expanded to Prosser in 2005.

o Started Statewide Denture Services, PLLC in 2007 to contract with Washington Department of Corrections. Later contract work includes Columbia Basin Health Association in Othello and Connell, and Premier Care Dental in Washington and Oregon.

2.4 Previous work with Department of Corrections

o First starting contracting with DOC in 2007.

o No complaints from inmates or staff.

o Worked with the officers and the dental departments to comply with custody level concerns and completion timelines.

o I bring all supplies for clinical work, no DOC supplies are used or need to be tracked and stocked by the dental department.

o I bring an itemized list of tools for the officers to check in anf

d out.

o I bring a notebook containing the MSDS’s for all items per requirement for a Department of Health Inspection.

2.5 Denture and partial process

o Average of 4 appointments for the fabrication of dentures and partials.

§ 1) Diagnostic impressions for maxillary and mandibular model.

§ 2) Bite registration to determine vertical dimension of occlusion (VDO), lip and smile line for tooth placement, and shade of tooth to be used. If we are fabricating a cast partial, we try-in the framework to ensure proper fit before setting teeth.

§ 3) Wax try-in of the waxed denture or partial teeth to ensure proper VDO, aesthetics, plane of occlusion. If this is approved by the denturist and the patient we use the waxed denture rims as custom trays for final impressions, ensure a good fit. If there is a need to reset the teeth for any reason, all resets are done at no charge to DOC.

§ 4) Delivery of the denture and/or partial along with a denture cup for safe keeping when not in use. Denture and partial hygiene instructions are given. All new dentures and partials are delivered with the inmates’ last name and DOC#.

2.6 Currently work with the following non-profit charities

o Grace Clinic

o Donated Dental Services

o Tri-City Amateur Hockey Association

o Mustangs for Mustangs

2.7 Continuing education (Listing only a few)

o Pathology

o Bruxism Devices

o Infection Control

o WISHA compliance training

o First aid / CPR

o Standard of Care practices

o Common office emergencies

o Denture implant case planning and procedures

o Difficult denture and partial cases and planning

Scope of Work

The contractor will provide removable prosthodontic services to offenders at the following prison facilities when such services are ordered by a DOC dentist in accordance with the Offender Health Plan:

· Washington Corrections Center – Shelton, WA,

· Washington Corrections Center for Women – Gig Harbor, WA,

· Monroe Correctional Complex – Monroe, WA,

· Stafford Creek Corrections Center – Aberdeen, WA,

· Washington State Penitentiary – Walla Walla, WA,

· Airway Heights Corrections Center – Airway Heights, WA,

· Coyote Ridge Corrections Center – Connell, WA, and

These services shall include:

· Clinical and laboratory services for the fabrication of full dentures.

· Clinical and laboratory services for the fabrication of acrylic partial dentures. These may include wrought wire clasps and prefabricated rests.

· Clinical and laboratory services for the fabrication of cast metal partial dentures and cast metal/ acrylic partial dentures as designed by the dentist and in accordance with department policy and guidelines.

· Adjustment and repair of existing removable prosthodontic devices, including relines and rebases as clinically appropriate.

Contractors are required to enter each service encounter into the DOC OMNI reporting system.

Clinical services will be provided in DOC dental clinics. All contracted clinical services will be provided by personnel licensed to practice in the State of Washington as a dentist or denturist. Laboratory services will be provided in the contractor’s laboratory.

"Denturist" means a person licensed under chapter 18.30 RCW to engage in the practice of denturism.

"Practice of denturism" means: (a) Making, placing, constructing, altering, reproducing, or repairing a denture; and (b) Taking impressions and furnishing or supplying a denture directly to a person or advising the use of a denture, and maintaining a facility for the same.

All prosthodontic devices provided will be fabricated from American Dental Association approved materials. Quality will be monitored by the facility dentist. In the event of a dispute between the contractor and the facility dentist, the DOC Director of Dental Services will be the final authority.

Contractor personnel will agree to abide by department policy in regard to the safety and security of the institution, including tool control policy. The contractor’s procedures will comply with CDC, Department, and facility regulations and protocols regarding infection control.

The Contractor will carry appropriate liability insurance including malpractice coverage.

The facility dentist shall keep a list of patients who need the services of the contractor, the type of services needed, and the date the patient was added to the list. The contractor will be expected to begin services for a patient within 8 weeks of the patient being added to the list. The contractor will deliver the completed prosthodontic device within 6 weeks of beginning it. This time can be extended by the facility dentist if warranted.

Additional compensation will not be allowed for remakes.

FEE SCHEDULE

VENDOR SERVICE AREA: Indicate your proposed service area; Eastern Washington, Western Washington, or the entire state of Washington.

FEE SCHEDULE: Indicate your fully inclusive cost to provide the following services:

D5110 Full upper denture

D5120 Full lower denture

*D5211/D5212 Acrylic Partial denture without clasps

*D5211/D5212 Acrylic Partial denture with wrought wire clasps.

Partial denture with cast chrome cobalt framework, and up to 4 clasps and 4 rests.

*D5213/D5214 Partial denture with cast chrome cobalt framework and more than 4 clasps and/or 4 rests.

D5750/D5751 Reline full denture

D5710/D5711 Rebase full denture

D5760/D5761 Reline partial denture

D5510 Simple acrylic repair of the full or partial denture. (repair of acrylic only, using self-cure acrylic processed in a pressure pot.)

D5660/D5650 Complex repair of the full or partial denture. (repair involving the addition and processing of additional elements to the prosthesis, such as additional teeth or clasps)

D9940 Night Guard

D7999 Hourly rate for purposes of site specific Department orientation.

*All billing for codes that have more than one price must be submitted with documentation attached to the claim that supports the pricing of the code. The documentation must clearly indicate the offenders' name and date of service.

REFERENCES

1.

2.

3. < state agency>

CERTTIFICATIONS AND ASSURANCES

I/we make the following certifications and assurances as a required element of the Bid to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract(s):

1. I/we declare that all answers and statements made in the Bid are true and correct.

2. The prices and/or cost data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single Bid.

3. The attached Bid is a firm offer for a period of 60 days following receipt, and it may be accepted by the DEPARTMENT without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 60-day period.

4. In preparing this Bid, I/we have not been assisted by any current or former employee of the state of Washington whose duties relate (or did relate) to this Bid or prospective contract, and who was assisting in other than his or her official, public capacity. (Any exceptions to these assurances are described in full detail on a separate page and attached to this document.)

5. I/we understand that the DEPARTMENT will not reimburse me/us for any costs incurred in the preparation of this Bid. All Bids become the property of the DEPARTMENT, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this Bid.

6. Unless otherwise required by law, the prices and/or cost data which have been submitted have not been knowingly disclosed by the Bidder and will not knowingly be disclosed by him/her prior to opening, directly or indirectly to any other Bidder or to any competitor.

7. I/we agree that submission of the attached Bid constitutes acceptance of the solicitation contents and the attached sample contract and general terms and conditions. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document.

8. No attempt has been made or will be made by the Bidder to induce any other person or firm to submit or not to submit a Bid for the purpose of restricting competition.

9. I/we grant the DEPARTMENT the right to contact references and others, who may have pertinent information regarding the Bidder’s prior experience and ability to perform the services contemplated in this procurement.

___________________________________________________

Signature of Bidder

___________________________________________________

Title Date

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