19GE5022R0052_Att1_Pricing.xlsx

XLSX spreadsheet 19 KB Posted

Attached to
Health Insurance for Locally Employed Staff, US Embassy Bangui, Central African Republic
Solicitation number
19GE5022R0052
Issued by

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Other files

File Type Posted
22R0052_Questions and Answers set one.pdf PDF
19GE5022R0052_0001..pdf PDF
Attachment 3 - Form W-14.pdf PDF
19GE5022R0052.pdf PDF
19GE5022R0052_Exhibit A.pdf PDF
Cover Letter_19GE5022R0052.pdf PDF
Attachment 2 - Experience and Past Performance.docx DOCX document

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Pricing Schedule

001 BASE YEAR
Sub CLINEstimated Number of employeesmonthly premiumTotal
001a Employee92- 0
001b Employee's Spouse63- 0
001c Employee's Dependent Children287- 0

e.subtotal (a+b+c) - 0 f.Total Price for Base Year (e x 12 Months ) - 0

1001 OPTION YEAR ONE
Sub CLINEstimated Numbermonthly premiumTotal
1001a Employee92- 0
1001b Employee's Spouse63- 0
1001c Employee's Dependent Children287- 0

e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR ONE (e x 12 Months ) - 0

2001 OPTION YEAR TWO
Sub CLINEstimated Numbermonthly premiumTotal
2001a Employee92- 0
2001b Employee's Spouse63- 0
2001c Employee's Dependent Children287- 0

e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR TWO (e x 12 Months ) - 0

3001 OPTION YEAR THREE
Sub CLINEstimated Numbermonthly premiumTotal
3001a Employee92- 0
3001b Employee's Spouse63- 0
3001c Employee's Dependent Children287- 0

e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR THREE (e x 12 Months ) - 0

4001 OPTION YEAR FOUR
Sub CLINEstimated Numbermonthly premiumTotal
4001a Employee92- 0
4001b Employee's Spouse63- 0
4001c Employee's Dependent Children287- 0

e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR FOUR (e x 12 Months ) - 0

GRAND TOTAL- 0
CURRENCY:

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