J.3. Pricing Template - 1605C3-24-R-00009 - updated.xlsx
XLSX spreadsheet 104 KB Posted
- Solicitation number
- 1605C3-24-R-00009
About this file
This document is a Pricing Template related to a federal contract opportunity for Nurse and Vocational Rehabilitation Case Management Services (NVRS). The contract opportunity has a solicitation number of 1605C3-24-R-00009 and is being issued by the U.S. Department of Labor, Office of Workers' Compensation Programs (U.S. DOL OWCP).
The Pricing Template provides detailed instructions and guidance for pricing various contract line items, including Triage Nurse Closure Reports, Field Nurse Regular and Site Visit Reports, SECOP Prep Packets, Rehabilitation Counselor Regular and Site Visit Reports, Vocational Rehabilitation Plans, and related travel and other direct expenses. Tier pricing is applied based on report submission timelines for certain deliverables. The "number of units" provided for each region are estimates for evaluation purposes only and do not represent actual contract quantities. Questions regarding the RFP are due by 5:00 PM EST on 06/07/2024.
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Other files
| File | Type | Posted |
|---|---|---|
| 1605C3-24-R-00009 Amendment 0002.pdf | ||
| Attach J.4- Region WD - 1605C3-24-R-00009-Updated.txt | TXT text file | |
| 1605C3-24-R-00009 Amendment 0001.pdf | ||
| Attachment J2 QA Spreadsheet - consolidated list.pdf | ||
| J.7 List of Proposed Contractor Personnel Template updated.xlsx | XLSX spreadsheet | |
| DMP Overview Updated.pptx | PPTX presentation | |
| J.3. Pricing Template - 1605C3-24-R-00009.xlsx | XLSX spreadsheet | |
| 1605C3-24-R-00009.pdf | ||
| J.8 DMP Overview Updated 1605C3-24-R-00009.pptx | PPTX presentation | |
| J.5 Past Performance Questionnaire - 1605C3-24-R-00009.docx | DOCX document | |
| Attach J.2-QA Spreadsheet - 1605C3-24-R-00009.xls | XLS spreadsheet | |
| J.1-QASP NVRS 1605C3-24-R-00009.docx | DOCX document | |
| Attach J.4- Region WD - 1605C3-24-R-00009.txt | TXT text file | |
| J. 6- Subcontracting Plan Template - 1605C3-24-R-00009.docx | DOCX document | |
| J.7 List of Proposed Contractor Personnel Template 1605C3-24-R-00009.xlsx | XLSX spreadsheet |
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Assumptions & Instructions
| Contract Line Item Number (CLIN) | Pricing Assumptions (Reference Technical Exhibit 4 of the PWS for additional information on the Regions) | Instructions |
| CLIN X001 | The established "number of units" by region for the Triage Nurse (TN) Closure Reports is a reasonable estimate based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-E (Average Monthly Number of TN Open cases/Monthly reports and Invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state. Example: Per Technical Exhibit 3-E, the overall monthly average # of TN open cases/ monthly reports and invoices is 931. Therefore, the overall annual average of TN open cases/ reports and invoices is 11,172 (931*12 months).
| 2. | Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Example: Per Technical Exhibit 3-E, the monthly average # of TN open cases/ monthly reports and invoices for the state of California is 83 and 0 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of TN open cases/ reports and invoices for region 8 is estimated at 996 (83*12 months). Hence, the number of units for the TN Closure Reports in Region 8 was estimated at 996. | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. |
| CLIN X002 | The established "number of units" by region for the Registered Field Nurses (FN) Regular Report* is a reasonable estimate based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
*As stated in the PWS, the FN completes either Regular Reports or Site visit Reports for each assigned case on a monthly basis. The FNs may also complete SECOP Prep Packets in addition to the Regular/Site Visit Reports, if applicable.
Tier pricing is applied based on submission date.
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-C (Average Monthly Number of FN Open cases/Monthly reports and Invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state. Example: Per Technical Exhibit 3-C, the overall monthly average # of FN open cases/ monthly reports and invoices is 3,711. Therefore, the overall estimated annual average of FN open cases/ reports and invoices is 44,532 (3,711x12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-C, the monthly average # of FN open cases/ monthly reports and invoices for the state of California is 399 and 0 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of FN open cases/ reports and invoices for region 8 is estimated at 4,788 (399 x 12 months). Hence, the annual average of FN open cases in region 8 (4,788) is 10.752% (4788/44,532)*100) of the overall estimated annual average of FN open cases/ reports and invoices (44,532).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, per historical data, the FN Regular Reports and respective invoices encompasses 65% or 28,946 (44532*.65=28,946) of the overall annual average of FN reports (44,532). Hence, to calculate the number of units for the FN Regular Report in Region 8, a 10.752% (region 8 annual percentage of FN open cases) was applied to 28,946 (estimated annual total of FN Regular reports) for a total of 3,112 (28,946*0.10752). | ||
| Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |||
| Tier 1 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| Tier 2 | Tier 2 pricing cell is locked for entry and will be calculated automatically. Any modifications are restricted | ||
| CLIN X003 | The established "number of units" by region for the FN Site Visit Report is based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
Tier pricing is applied based on submission date.
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-C (Average Monthly Number of FN Open cases/Monthly reports and Invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state. Example: Per Technical Exhibit 3-C, the overall monthly average # of FN open cases/ monthly reports and invoices is 3,711. Therefore, the overall estimated annual average of FN open cases/ reports and invoices is 44,532 (3,711*12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-C, the monthly average # of FN open cases/ monthly reports and invoices for the state of California is 399 and 0 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of FN open cases/ reports and invoices for region 8 is estimated at 4,788 (399 x 12 months). Hence, the annual average of FN open cases in region 8 (4,788) is 10.752% ((4788/44,532)*100)) of the overall estimated annual average of FN open cases/ reports and invoices (44,532).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, per historical data, the FN Site Visit Reports and respective invoices encompasses 35% or 15,586 (44532*.35=15,586) of the overall annual average of FN reports (44,532). Hence, to calculate the number of units for the FN Site Visit Report in Region 8, a 10.752% (region 8 annual percentage of FN open cases) was applied to 15,586 (estimated annual total of FN Site Visit reports) for a total of 1,676 (15,586*0.10752). | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |
| Tier 1 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| Tier 2 | Tier 2 pricing cell is locked for entry, and will be calculated automatically | ||
| CLIN X004 | The established "number of units" by region is a reasonable estimate and does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. The "per unit rate "should be based on the GSA Mileage rates: https://www.gsa.gov/travel/plan-book/transportation-airfare-pov-etc/privately-owned-vehicle-mileage-rates/pov-mileage-rates-archived. | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |
| CLIN X005 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| CLIN X006 | The established "number of units" by region for the SECOP Prep Packet is a reasonable estimate based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-C (Average Monthly Number of FN Open cases/Monthly reports and Invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state. Example: Per Technical Exhibit 3-C, the overall monthly average # of FN open cases/ monthly reports and invoices is 3,711. Therefore, the overall estimated annual average of FN open cases/ reports and invoices is 44,532 (3,711*12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-C, the monthly average # of FN open cases/ monthly reports and invoices for the state of California is 399 and 0 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of FN open cases/ reports and invoices for region 8 is estimated at 4,788 (399 x 12 months). Hence, the annual average of FN open cases in region 8 (4,788) is 10.752% ((4788/44,532)*100)) of the overall estimated annual average of FN open cases/ reports and invoices (44,532).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, it is estimated that 15% or 6,680 reports (44532*.15=6,680) of the annual average number of Nurse Reports (44,532) will need a SECOP Prep Packet and respective invoice in addition to the FN Regular/Site visit report. Hence, to calculate the number of units for the SECOP Prep Packet in Region 8, a 10.752% (region 8 annual percentage of FN open cases) was applied to 6,680 (estimated annual total of SECOP Prep packets) for a total of 718 (6,680*0.10752). | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. |
| CLIN X007 | The established "number of units" by region for the Rehabilitation Counselor (RC) Regular Report* is a reasonable estimate based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
*As stated in the PWS, the RC complete either Regular Reports or Site Visit Reports for each assigned case on a monthly basis. The RCs may also complete Vocational Rehabilitation Plans in addition to the Regular/Site Visit Reports, if applicable.
Tier pricing is applied based on submission date.
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-D (Average Monthly Number of RC Open cases/monthly reports and invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state and overall. Example: Per Technical Exhibit 3-D, the overall monthly average # of RC open cases/ monthly reports and invoices is 1,593. Therefore, the overall estimated annual average of RC open cases/ reports and invoices is 19,116 (1,593 x12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-D, the average # of RC open cases/ monthly reports and invoices, for the state of California is 196 and 1 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of RC open cases/ reports and invoices for region 8 is estimated at 2,364 ((196+1) x 12 months)). Hence, the annual average of RC open cases in region 8 (2,364) is 12.304% ((2364/19116)*100)) of the overall estimated annual average of RC open cases/ reports and invoices (19,116).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, per historical data, the RC Regular Reports and respective invoices encompasses 65% or 12,425 (19,116*.65=12,425) of the overall annual average of RC reports (19,116). Hence, to calculate the number of units for the RC Regular Report in Region 8, a 12.304% (region 8 annual percentage of RC open cases) was applied to 12,425 (estimated annual total of RC Regular reports) for a total of 3,112 (12,425*0.12304). | ||
| Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |||
| Tier 1 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| Tier 2 | Tier 2 pricing cell is locked for entry and will be calculated automatically. Any modifications are restricted | ||
| CLIN X008 | The established "number of units" by region for the RC Site Visit Report is a reasonable estimate based on the data provided in Technical Exhibit 3 but does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. |
Tier pricing is applied based on submission date.
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-D (Average Monthly Number of RC Open cases/monthly reports and invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state and overall. Example: Per Technical Exhibit 3-D, the overall monthly average # of RC open cases/ monthly reports and invoices is 1,593. Therefore, the overall estimated annual average of RC open cases/ reports and invoices is 19,116 (1,593 x12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-D, the average # of RC open cases/ monthly reports and invoices, for the state of California is 196 and 1 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of RC open cases/ reports and invoices for region 8 is estimated at 2,364 ((196+1) x 12 months)). Hence, the annual average of RC open cases in region 8 (2,364) is 12.304% ((2364/19116)*100)) of the overall estimated annual average of RC open cases/ reports and invoices (19,116).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, per historical data, the RC Site Visit Reports and respective invoices encompasses 35% or 6,691 (19,116*.35=6,691) of the overall annual average of RC reports (19,116). Hence, to calculate the number of units for the RC Site Visit Report in Region 8, a 12.304% (region 8 annual percentage of RC open cases) was applied to 6,691 (estimated annual total of RC Site Visit reports) for a total of 823 (6,691*0.12304). | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |
| Tier 1 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| Tier 2 | Tier 2 pricing cell is locked for entry and will be calculated automatically. Any modifications are restricted | ||
| CLIN X009 | The established "number of units" by region for the Vocational Rehabilitation Plan is a reasonable estimate based on historical data/annual average. However, the established "number of units" by region are provided for evaluation purposes only and do not represent/limit the actual "number of units" by region in the contract to be awarded. |
Tier pricing is applied based on submission date.
The established "number of units" by region were calculated as follows:
1. Used Technical Exhibit 3-D (Average Monthly Number of RC Open cases/monthly reports and invoices) and multiplied the numbers by 12 to calculate the estimated annual average by state and overall. Example: Per Technical Exhibit 3-D, the overall monthly average # of RC open cases/ monthly reports and invoices is 1,593. Therefore, the overall estimated annual average of RC open cases/ reports and invoices is 19,116 (1,593 x12 months).
2. Assigned the resulting state’s annual average to the respective region (per Technical Exhibit 4). Calculated a percentage per region. Example: Per Technical Exhibit 3-D, the average # of RC open cases/ monthly reports and invoices, for the state of California is 196 and 1 for Virgin Islands. California is the only state assigned to region 8 and Virgin Islands has been designated under Region 8 for pricing purposes only. Therefore, the annual average of RC open cases/ reports and invoices for region 8 is estimated at 2,364 ((196+1) x 12 months)). Hence, the annual average of RC open cases in region 8 (2,364) is 12.304% ((2364/19116)*100)) of the overall estimated annual average of RC open cases/ reports and invoices (19,116).
| 3. | Applied the resulting percentage to the total annual average for the respective billable work product. Example: As stated in Technical Exhibit 3-A, per historical data, the anticipated annual number of RC Vocational Rehabilitation Plan is 3,989. Hence, to calculate the number of units for the Vocational Rehabilitation Plan in Region 8, a 12.304% (region 8 annual percentage of RC open cases) was applied to 3,989 (estimated annual total of Vocational Rehabilitation Plans) for a total of 491 (3,989*0.12304). | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |
| Tier 1 | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | ||
| Tier 2 | Tier 2 pricing cell is locked for entry and will be calculated automatically. Any modifications are restricted | ||
| CLIN X010 | The established "number of units" by region is a reasonable estimate and does not represent/limit the actual "number of units" by region in the contract to be awarded. The established "number of units" by region are provided for evaluation purposes only. The "per unit rate "should be based on the GSA Mileage rates: https://www.gsa.gov/travel/plan-book/transportation-airfare-pov-etc/privately-owned-vehicle-mileage-rates/pov-mileage-rates-archived. | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. | |
| CLIN X011 | The Not To Exceed (NTE) amounts are based on resonable estimates and included into total calculations. | RC Other Direct Expenses, NTE" in Excel comes pre-populated and is locked for data entry. Any modifications are restricted | |
| CLIN X012 | The established "number of units" by region for Longshore VR cases is a reasonable estimate and is based on historical data/annual average. Historically, the cost per case is approximately $2,900. | Please input pricing into the cells highlighted in yellow, as shown here. Subtotals will be calculated automatically. |
Pricing Template
| Period of Performance | Contract Line Item Number (CLIN) | Item Description | Unit Measure | Region 1 | Region 2 | Region 3 | Region 4 | Region 5 | Region 6 | Region 7 | Region 8 | Region 9 | Region 10 | SUBTOTALS (Base Pricing only) | ||||||||||||||||||||
| # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | # of units (for evaluation only; not actual numbers) | Proposed Price per unit | Total | |||||
| BASE PERIOD | CLIN 0001 | Triage Nurse Closure Report | Case | 2,256 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 504 | $ - 0 | $ - 0 | 2,880 | $ - 0 | $ - 0 | 1,716 | $ - 0 | $ - 0 | 1,236 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 996 | $ - 0 | $ - 0 | 120 | $ - 0 | $ - 0 | 24 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 0002 | FN Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 3,845 | $ - 0 | $ - 0 | 2,200 | $ - 0 | $ - 0 | 1,318 | $ - 0 | $ - 0 | 7,410 | $ - 0 | $ - 0 | 3,845 | $ - 0 | $ - 0 | 5,398 | $ - 0 | $ - 0 | 1,427 | $ - 0 | $ - 0 | 3,112 | $ - 0 | $ - 0 | 335 | $ - 0 | $ - 0 | 56 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | Each | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||||||||||
| CLIN 0003 | FN Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 2,071 | $ - 0 | $ - 0 | 1,184 | $ - 0 | $ - 0 | 710 | $ - 0 | $ - 0 | 3,990 | $ - 0 | $ - 0 | 2,071 | $ - 0 | $ - 0 | 2,906 | $ - 0 | $ - 0 | 769 | $ - 0 | $ - 0 | 1,676 | $ - 0 | $ - 0 | 181 | $ - 0 | $ - 0 | 28 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | Each | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||||||||||
| CLIN 0004 | FN Travel GSA Milage Charge | Miles | 236,936 | $ - 0 | $ - 0 | 135,529 | $ - 0 | $ - 0 | 81,222 | $ - 0 | $ - 0 | 456,571 | $ - 0 | $ - 0 | 236,936 | $ - 0 | $ - 0 | 332,576 | $ - 0 | $ - 0 | 87,950 | $ - 0 | $ - 0 | 191,760 | $ - 0 | $ - 0 | 20,666 | $ - 0 | $ - 0 | 3,364 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 0005 | FN Other Direct Expenses | Actual | $ - 0 | |||||||||||||||||||||||||||||||
| CLIN 0006 | SECOP Prep Packet | Each | 887 | $ - 0 | $ - 0 | 508 | $ - 0 | $ - 0 | 304 | $ - 0 | $ - 0 | 1,710 | $ - 0 | $ - 0 | 887 | $ - 0 | $ - 0 | 1,246 | $ - 0 | $ - 0 | 329 | $ - 0 | $ - 0 | 718 | $ - 0 | $ - 0 | 77 | $ - 0 | $ - 0 | 14 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 0007 | RC Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 1,755 | $ - 0 | $ - 0 | 616 | $ - 0 | $ - 0 | 959 | $ - 0 | $ - 0 | 3,276 | $ - 0 | $ - 0 | 1,154 | $ - 0 | $ - 0 | 2,738 | $ - 0 | $ - 0 | 250 | $ - 0 | $ - 0 | 1,529 | $ - 0 | $ - 0 | 109 | $ - 0 | $ - 0 | 39 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 0008 | RC Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 945 | $ - 0 | $ - 0 | 332 | $ - 0 | $ - 0 | 517 | $ - 0 | $ - 0 | 1,764 | $ - 0 | 622 | $ - 0 | $ - 0 | 1,474 | $ - 0 | $ - 0 | 134 | $ - 0 | $ - 0 | 823 | $ - 0 | $ - 0 | 59 | $ - 0 | $ - 0 | 21 | $ - 0 | $ - 0 | $ - 0 | ||
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 0009 | Vocational Rehabilitation Plan | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 121- 150 calendar days after the day of the RC assignment. | Each | 563 | $ - 0 | $ - 0 | 198 | $ - 0 | $ - 0 | 308 | $ - 0 | $ - 0 | 1,052 | $ - 0 | $ - 0 | 371 | $ - 0 | $ - 0 | 879 | $ - 0 | $ - 0 | 80 | $ - 0 | $ - 0 | 491 | $ - 0 | $ - 0 | 35 | $ - 0 | $ - 0 | 12 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and conforming report is submitted within 120 calendar days after the day of the of the RC assignment. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 0010 | RC Travel GSA Milage Charge | Miles | 48,488 | $ - 0 | $ - 0 | 17,025 | $ - 0 | $ - 0 | 26,507 | $ - 0 | $ - 0 | 90,511 | $ - 0 | $ - 0 | 31,894 | $ - 0 | $ - 0 | 75,641 | $ - 0 | $ - 0 | 6,896 | $ - 0 | $ - 0 | 42,238 | $ - 0 | $ - 0 | 3,017 | $ - 0 | $ - 0 | 1,078 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 0011 | RC Other Direct Expenses, NTE | Actual | $ 332,931.33 | |||||||||||||||||||||||||||||||
| CLIN 0012 | Longshore VR cases | Case | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | $ - 0 | |
| Total of Base Period | $ 332,931.33 |
| OPTION PERIOD 1 | CLIN 1001 | Triage Nurse Closure Report | Case | 2,256 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 504 | $ - 0 | $ - 0 | 2,880 | $ - 0 | $ - 0 | 1,716 | $ - 0 | $ - 0 | 1,236 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 996 | $ - 0 | $ - 0 | 120 | $ - 0 | $ - 0 | 24 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 1002 | FN Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 3,845 | $ - 0 | $ - 0 | 2,200 | $ - 0 | $ - 0 | 1,318 | $ - 0 | $ - 0 | 7,410 | $ - 0 | $ - 0 | 3,845 | $ - 0 | $ - 0 | 5,398 | $ - 0 | $ - 0 | 1,427 | $ - 0 | $ - 0 | 3,112 | $ - 0 | $ - 0 | 335 | $ - 0 | $ - 0 | 56 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 1003 | FN Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 2,071 | $ - 0 | $ - 0 | 1,184 | $ - 0 | $ - 0 | 710 | $ - 0 | $ - 0 | 3,990 | $ - 0 | $ - 0 | 2,071 | $ - 0 | $ - 0 | 2,906 | $ - 0 | $ - 0 | 769 | $ - 0 | $ - 0 | 1,676 | $ - 0 | $ - 0 | 181 | $ - 0 | $ - 0 | 28 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 1004 | FN Travel GSA Milage Charge | Miles | 236,936 | $ - 0 | $ - 0 | 135,529 | $ - 0 | $ - 0 | 81,222 | $ - 0 | $ - 0 | 456,571 | $ - 0 | $ - 0 | 236,936 | $ - 0 | $ - 0 | 332,576 | $ - 0 | $ - 0 | 87,950 | $ - 0 | $ - 0 | 191,760 | $ - 0 | $ - 0 | 20,666 | $ - 0 | $ - 0 | 3,364 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 1005 | FN Other Direct Expenses | Actual | $ - 0 | |||||||||||||||||||||||||||||||
| CLIN 1006 | SECOP Prep Packet | Each | 887 | $ - 0 | $ - 0 | 508 | $ - 0 | $ - 0 | 304 | $ - 0 | $ - 0 | 1,710 | $ - 0 | $ - 0 | 887 | $ - 0 | $ - 0 | 1,246 | $ - 0 | $ - 0 | 329 | $ - 0 | $ - 0 | 718 | $ - 0 | $ - 0 | 77 | $ - 0 | $ - 0 | 14 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 1007 | RC Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 1,755 | $ - 0 | $ - 0 | 616 | $ - 0 | $ - 0 | 959 | $ - 0 | $ - 0 | 3,276 | $ - 0 | $ - 0 | 1,154 | $ - 0 | $ - 0 | 2,738 | $ - 0 | $ - 0 | 250 | $ - 0 | $ - 0 | 1,529 | $ - 0 | $ - 0 | 109 | $ - 0 | $ - 0 | 39 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 1008 | RC Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 945 | $ - 0 | $ - 0 | 332 | $ - 0 | $ - 0 | 517 | $ - 0 | $ - 0 | 1,764 | $ - 0 | $ - 0 | 622 | $ - 0 | $ - 0 | 1,474 | $ - 0 | $ - 0 | 134 | $ - 0 | $ - 0 | 823 | $ - 0 | $ - 0 | 59 | $ - 0 | $ - 0 | 21 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 1009 | Vocational Rehabilitation Plan | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 121- 150 calendar days after the day of the RC assignment. | Each | 563 | $ - 0 | $ - 0 | 198 | $ - 0 | $ - 0 | 308 | $ - 0 | $ - 0 | 1,052 | $ - 0 | $ - 0 | 371 | $ - 0 | $ - 0 | 879 | $ - 0 | $ - 0 | 80 | $ - 0 | $ - 0 | 491 | $ - 0 | $ - 0 | 35 | $ - 0 | $ - 0 | 12 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and conforming report is submitted within 120 calendar days after the day of the of the RC assignment. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 1010 | RC Travel GSA Milage Charge | Miles | 48,488 | $ - 0 | $ - 0 | 17,025 | $ - 0 | $ - 0 | 26,507 | $ - 0 | $ - 0 | 90,511 | $ - 0 | $ - 0 | 31,894 | $ - 0 | $ - 0 | 75,641 | $ - 0 | $ - 0 | 6,896 | $ - 0 | $ - 0 | 42,238 | $ - 0 | $ - 0 | 3,017 | $ - 0 | $ - 0 | 1,078 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 1011 | RC Other Direct Expenses, NTE | Actual | $ 342,919.27 | |||||||||||||||||||||||||||||||
| CLIN 1012 | Longshore VR cases | Case | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | $ - 0 | |
| Total of Option Period 1 | $ 342,919.27 |
| OPTION PERIOD 2 | CLIN 2001 | Triage Nurse Closure Report | Case | 2,256 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 504 | $ - 0 | $ - 0 | 2,880 | $ - 0 | $ - 0 | 1,716 | $ - 0 | $ - 0 | 1,236 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 996 | $ - 0 | $ - 0 | 120 | $ - 0 | $ - 0 | 24 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 2002 | FN Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 3,845 | $ - 0 | $ - 0 | 2,200 | $ - 0 | $ - 0 | 1,318 | $ - 0 | $ - 0 | 7,410 | $ - 0 | $ - 0 | 3,845 | $ - 0 | $ - 0 | 5,398 | $ - 0 | $ - 0 | 1,427 | $ - 0 | $ - 0 | 3,112 | $ - 0 | $ - 0 | 335 | $ - 0 | $ - 0 | 56 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||||||||||
| CLIN 2003 | FN Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 2,071 | $ - 0 | $ - 0 | 1,184 | $ - 0 | $ - 0 | 710 | $ - 0 | $ - 0 | 3,990 | $ - 0 | $ - 0 | 2,071 | $ - 0 | $ - 0 | 2,906 | $ - 0 | $ - 0 | 769 | $ - 0 | $ - 0 | 1,676 | $ - 0 | $ - 0 | 181 | $ - 0 | $ - 0 | 28 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 2004 | FN Travel GSA Milage Charge | Miles | 236,936 | $ - 0 | $ - 0 | 135,529 | $ - 0 | $ - 0 | 81,222 | $ - 0 | $ - 0 | 456,571 | $ - 0 | $ - 0 | 236,936 | $ - 0 | $ - 0 | 332,576 | $ - 0 | $ - 0 | 87,950 | $ - 0 | $ - 0 | 191,760 | $ - 0 | $ - 0 | 20,666 | $ - 0 | $ - 0 | 3,364 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 2005 | FN Other Direct Expenses | Actual | $ - 0 | |||||||||||||||||||||||||||||||
| CLIN 2006 | SECOP Prep Packet | Each | 887 | $ - 0 | $ - 0 | 508 | $ - 0 | $ - 0 | 304 | $ - 0 | $ - 0 | 1,710 | $ - 0 | $ - 0 | 887 | $ - 0 | $ - 0 | 1,246 | $ - 0 | $ - 0 | 329 | $ - 0 | $ - 0 | 718 | $ - 0 | $ - 0 | 77 | $ - 0 | $ - 0 | 14 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 2007 | RC Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 1,755 | $ - 0 | $ - 0 | 616 | $ - 0 | $ - 0 | 959 | $ - 0 | $ - 0 | 3,276 | $ - 0 | $ - 0 | 1,154 | $ - 0 | $ - 0 | 2,738 | $ - 0 | $ - 0 | 250 | $ - 0 | $ - 0 | 1,529 | $ - 0 | $ - 0 | 109 | $ - 0 | $ - 0 | 39 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 2008 | RC Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 945 | $ - 0 | $ - 0 | 332 | $ - 0 | $ - 0 | 517 | $ - 0 | $ - 0 | 1,764 | $ - 0 | $ - 0 | 622 | $ - 0 | $ - 0 | 1,474 | $ - 0 | $ - 0 | 134 | $ - 0 | $ - 0 | 823 | $ - 0 | $ - 0 | 59 | $ - 0 | $ - 0 | 21 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 2009 | Vocational Rehabilitation Plan | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 121- 150 calendar days after the day of the RC assignment. | Each | 563 | $ - 0 | $ - 0 | 198 | $ - 0 | $ - 0 | 308 | $ - 0 | $ - 0 | 1,052 | $ - 0 | $ - 0 | 371 | $ - 0 | $ - 0 | 879 | $ - 0 | $ - 0 | 80 | $ - 0 | $ - 0 | 491 | $ - 0 | $ - 0 | 35 | $ - 0 | $ - 0 | 12 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and conforming report is submitted within 120 calendar days after the day of the of the RC assignment. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 2010 | RC Travel GSA Milage Charge | Miles | 48,488 | $ - 0 | $ - 0 | 17,025 | $ - 0 | $ - 0 | 26,507 | $ - 0 | $ - 0 | 90,511 | $ - 0 | $ - 0 | 31,894 | $ - 0 | $ - 0 | 75,641 | $ - 0 | $ - 0 | 6,896 | $ - 0 | $ - 0 | 42,238 | $ - 0 | $ - 0 | 3,017 | $ - 0 | $ - 0 | 1,078 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 2011 | RC Other Direct Expenses, NTE | Actual | $ 353,206.85 | |||||||||||||||||||||||||||||||
| CLIN 2012 | Longshore VR cases | Case | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | $ - 0 | |
| Total of Option Period 2 | $ 353,206.85 |
| OPTION PERIOD 3 | CLIN 3001 | Triage Nurse Closure Report | Case | 2,256 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 504 | $ - 0 | $ - 0 | 2,880 | $ - 0 | $ - 0 | 1,716 | $ - 0 | $ - 0 | 1,236 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 996 | $ - 0 | $ - 0 | 120 | $ - 0 | $ - 0 | 24 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 3002 | FN Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 3,845 | $ - 0 | $ - 0 | 2,200 | $ - 0 | $ - 0 | 1,318 | $ - 0 | $ - 0 | 7,410 | $ - 0 | $ - 0 | 3,845 | $ - 0 | $ - 0 | 5,398 | $ - 0 | $ - 0 | 1,427 | $ - 0 | $ - 0 | 3,112 | $ - 0 | $ - 0 | 335 | $ - 0 | $ - 0 | 56 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 3003 | FN Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 2,071 | $ - 0 | $ - 0 | 1,184 | $ - 0 | $ - 0 | 710 | $ - 0 | $ - 0 | 3,990 | $ - 0 | $ - 0 | 2,071 | $ - 0 | $ - 0 | 2,906 | $ - 0 | $ - 0 | 769 | $ - 0 | $ - 0 | 1,676 | $ - 0 | $ - 0 | 181 | $ - 0 | $ - 0 | 28 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 3004 | FN Travel GSA Milage Charge | Miles | 236,936 | $ - 0 | $ - 0 | 135,529 | $ - 0 | $ - 0 | 81,222 | $ - 0 | $ - 0 | 456,571 | $ - 0 | $ - 0 | 236,936 | $ - 0 | $ - 0 | 332,576 | $ - 0 | $ - 0 | 87,950 | $ - 0 | $ - 0 | 191,760 | $ - 0 | $ - 0 | 20,666 | $ - 0 | $ - 0 | 3,364 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 3005 | FN Other Direct Expenses | Actual | $ - 0 | |||||||||||||||||||||||||||||||
| CLIN 3006 | SECOP Prep Packet | Each | 887 | $ - 0 | $ - 0 | 508 | $ - 0 | $ - 0 | 304 | $ - 0 | $ - 0 | 1,710 | $ - 0 | $ - 0 | 887 | $ - 0 | $ - 0 | 1,246 | $ - 0 | $ - 0 | 329 | $ - 0 | $ - 0 | 718 | $ - 0 | $ - 0 | 77 | $ - 0 | $ - 0 | 14 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 3007 | RC Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 1,755 | $ - 0 | $ - 0 | 616 | $ - 0 | $ - 0 | 959 | $ - 0 | $ - 0 | 3,276 | $ - 0 | $ - 0 | 1,154 | $ - 0 | $ - 0 | 2,738 | $ - 0 | $ - 0 | 250 | $ - 0 | $ - 0 | 1,529 | $ - 0 | $ - 0 | 109 | $ - 0 | $ - 0 | 39 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 3008 | RC Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 945 | $ - 0 | $ - 0 | 332 | $ - 0 | $ - 0 | 517 | $ - 0 | $ - 0 | 1,764 | $ - 0 | $ - 0 | 622 | $ - 0 | $ - 0 | 1,474 | $ - 0 | $ - 0 | 134 | $ - 0 | $ - 0 | 823 | $ - 0 | $ - 0 | 59 | $ - 0 | $ - 0 | 21 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 3009 | Vocational Rehabilitation Plan | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 121- 150 calendar days after the day of the RC assignment. | Each | 563 | $ - 0 | $ - 0 | 198 | $ - 0 | $ - 0 | 308 | $ - 0 | $ - 0 | 1,052 | $ - 0 | $ - 0 | 371 | $ - 0 | $ - 0 | 879 | $ - 0 | $ - 0 | 80 | $ - 0 | $ - 0 | 491 | $ - 0 | $ - 0 | 35 | $ - 0 | $ - 0 | 12 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and conforming report is submitted within 120 calendar days after the day of the of the RC assignment. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 3010 | RC Travel GSA Milage Charge | Miles | 48,488 | $ - 0 | $ - 0 | 17,025 | $ - 0 | $ - 0 | 26,507 | $ - 0 | $ - 0 | 90,511 | $ - 0 | $ - 0 | 31,894 | $ - 0 | $ - 0 | 75,641 | $ - 0 | $ - 0 | 6,896 | $ - 0 | $ - 0 | 42,238 | $ - 0 | $ - 0 | 3,017 | $ - 0 | $ - 0 | 1,078 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 3011 | RC Other Direct Expenses, NTE | Actual | $ 363,803.05 | |||||||||||||||||||||||||||||||
| CLIN 3012 | Longshore VR cases | Case | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | $ - 0 | |
| Total of Option Period 3 | $ 363,803.05 |
| OPTION PERIOD 4 | CLIN 4001 | Triage Nurse Closure Report | Case | 2,256 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 504 | $ - 0 | $ - 0 | 2,880 | $ - 0 | $ - 0 | 1,716 | $ - 0 | $ - 0 | 1,236 | $ - 0 | $ - 0 | 720 | $ - 0 | $ - 0 | 996 | $ - 0 | $ - 0 | 120 | $ - 0 | $ - 0 | 24 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 4002 | FN Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 3,845 | $ - 0 | $ - 0 | 2,200 | $ - 0 | $ - 0 | 1,318 | $ - 0 | $ - 0 | 7,410 | $ - 0 | $ - 0 | 3,845 | $ - 0 | $ - 0 | 5,398 | $ - 0 | $ - 0 | 1,427 | $ - 0 | $ - 0 | 3,112 | $ - 0 | $ - 0 | 335 | $ - 0 | $ - 0 | 56 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 4003 | FN Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 2,071 | $ - 0 | $ - 0 | 1,184 | $ - 0 | $ - 0 | 710 | $ - 0 | $ - 0 | 3,990 | $ - 0 | $ - 0 | 2,071 | $ - 0 | $ - 0 | 2,906 | $ - 0 | $ - 0 | 769 | $ - 0 | $ - 0 | 1,676 | $ - 0 | $ - 0 | 181 | $ - 0 | $ - 0 | 28 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 4004 | FN Travel GSA Milage Charge | Miles | 236,936 | $ - 0 | $ - 0 | 135,529 | $ - 0 | $ - 0 | 81,222 | $ - 0 | $ - 0 | 456,571 | $ - 0 | $ - 0 | 236,936 | $ - 0 | $ - 0 | 332,576 | $ - 0 | $ - 0 | 87,950 | $ - 0 | $ - 0 | 191,760 | $ - 0 | $ - 0 | 20,666 | $ - 0 | $ - 0 | 3,364 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 4005 | FN Other Direct Expenses | Actual | $ - 0 | |||||||||||||||||||||||||||||||
| CLIN 4006 | SECOP Prep Packet | Each | 887 | $ - 0 | $ - 0 | 508 | $ - 0 | $ - 0 | 304 | $ - 0 | $ - 0 | 1,710 | $ - 0 | $ - 0 | 887 | $ - 0 | $ - 0 | 1,246 | $ - 0 | $ - 0 | 329 | $ - 0 | $ - 0 | 718 | $ - 0 | $ - 0 | 77 | $ - 0 | $ - 0 | 14 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 4007 | RC Regular Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 1,755 | $ - 0 | $ - 0 | 616 | $ - 0 | $ - 0 | 959 | $ - 0 | $ - 0 | 3,276 | $ - 0 | $ - 0 | 1,154 | $ - 0 | $ - 0 | 2,738 | $ - 0 | $ - 0 | 250 | $ - 0 | $ - 0 | 1,529 | $ - 0 | $ - 0 | 109 | $ - 0 | $ - 0 | 39 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 4008 | RC Site Visit Report | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-30 calendar days after the end date of the monthly service period. | Each | 945 | $ - 0 | $ - 0 | 332 | $ - 0 | $ - 0 | 517 | $ - 0 | $ - 0 | 1,764 | $ - 0 | $ - 0 | 622 | $ - 0 | $ - 0 | 1,474 | $ - 0 | $ - 0 | 134 | $ - 0 | $ - 0 | 823 | $ - 0 | $ - 0 | 59 | $ - 0 | $ - 0 | 21 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after the end date of the monthly service period. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 4009 | Vocational Rehabilitation Plan | |||||||||||||||||||||||||||||||||
| Tier 1 | Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 121- 150 calendar days after the day of the RC assignment. | Each | 563 | $ - 0 | $ - 0 | 198 | $ - 0 | $ - 0 | 308 | $ - 0 | $ - 0 | 1,052 | $ - 0 | $ - 0 | 371 | $ - 0 | $ - 0 | 879 | $ - 0 | $ - 0 | 80 | $ - 0 | $ - 0 | 491 | $ - 0 | $ - 0 | 35 | $ - 0 | $ - 0 | 12 | $ - 0 | $ - 0 | $ - 0 | |
| Tier 2 | Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and conforming report is submitted within 120 calendar days after the day of the of the RC assignment. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||
| CLIN 4010 | RC Travel GSA Milage Charge | Miles | 48,488 | $ - 0 | $ - 0 | 17,025 | $ - 0 | $ - 0 | 26,507 | $ - 0 | $ - 0 | 90,511 | $ - 0 | $ - 0 | 31,894 | $ - 0 | $ - 0 | 75,641 | $ - 0 | $ - 0 | 6,896 | $ - 0 | $ - 0 | 42,238 | $ - 0 | $ - 0 | 3,017 | $ - 0 | $ - 0 | 1,078 | $ - 0 | $ - 0 | $ - 0 | |
| CLIN 4011 | RC Other Direct Expenses, NTE | Actual | $ 374,717.15 | |||||||||||||||||||||||||||||||
| CLIN 4012 | Longshore VR cases | Case | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | 2 | $ - 0 | $ - 0 | $ - 0 | |
| Total of Option Period 4 | $ 374,717.15 |
Summary
| Period of Performance | Total |
| Base Period | $ 332,931.33 |
| Option Period 1 | $ 342,919.27 |
| Option Period 2 | $ 353,206.85 |
| Option Period 3 | $ 363,803.05 |
| Option Period 4 | $ 374,717.15 |
| Total Evaluated Price: | $ 1,767,577.65 |
| DESCRIPTION OF WORK | Tier pricing |
| Triage Nurse Closure Report/ documentation in DMP | No tier pricing applied. |
| FN Regular Report | Tier pricing is applied based on submission date. |
| FN Site Visit Report | Tier pricing is applied based on submission date. |
| FN Travel GSA Milage Charge | No tier pricing applied. |
| FN Other Direct Expenses | No tier pricing applied. |
| SECOP Prep Packet | No tier pricing applied. |
| RC Regular Report | Tier pricing is applied based on submission date. |
| RC Site Visit Report | Tier pricing is applied based on submission date. |
| Vocational Rehabilitation Plan | Tier pricing is applied based on submission date. |
| RC Travel GSA Milage Charge | No tier pricing applied. |
| RC Other Direct Expenses | No tier pricing applied. |
| Longshore VR cases | No tier pricing applied. |
File details come from the government source that posted it. Updated .