22 CC-BLRI002-27 Appendix B PSF4 Forms.xlsx
XLSX spreadsheet 64 KB Posted
- Solicitation number
- CC-BLRI007-27
About this file
This file is an appendix containing PSF4 Forms templates for the concession contract solicitation. The document provides standardized forms that prospective offerors must complete and submit as part of their proposal packages for the Craft Sales and Retail concession opportunity at the Northwest Trading Post within Blue Ridge Parkway. PSF4 forms are required federal contracting documents used in the National Park Service concession contract process to gather specific business and operational information from bidders. The templates establish uniform formatting and data collection requirements to ensure consistent evaluation of all proposals submitted in response to solicitation CC-BLRI007-27. Prospective offerors should refer to these forms when preparing their complete proposals, which must be submitted by September 17, 2026, at 12:00 p.m., with the transmittal letter mailed to the NPS Concessions Office in Atlanta and remaining proposal materials submitted electronically as directed in the proposal instructions.
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Text version
Investments Form
INITIAL INVESTMENTS AND START-UP EXPENSES FORM
Grey Cells Are Input Cells
Name of Offeror
CONCID BLRI002-27
| Assets |
| Existing Assets |
| Assets necessary to the operation of the Concession, already owned by the Offeror, that will be allocated to the |
| operation of the Draft Contract. |
| Real Property (not within the Park) |
| Personal Property |
| Inventory and Supplies |
| Other (describe) |
Subtotal $0
| Planned Asset Acquisition |
| Assets necessary to Operate the Concession, that will be acquired by the Offeror if awarded the Draft Contract. |
| Real Property (not within the Park) |
| Personal Property |
| Inventory and Supplies |
| Other (describe) |
Subtotal $0
Total $0
Other
| Deferred Maintenance |
| Start-Up Expenses |
| Working Capital |
| Other (describe) |
Total $0
Total Initial Investments and Start-up Expenses $0
| Notes |
| 1) Formulas included in this form are provided by the NPS as guidance only. The Offeror is responsible for its financial |
| projections and their accuracy. |
2) Yellow cells represent categories that need to be explained on the "Investments Assumptions" worksheet.
| 3) All Offerors must include their estimate of the value of all property intended, whether planned for acquisition or currently |
| owned, for use in the Draft Contract. |
| 4) The items indicated above are the estimated planned expenditures for initial investment, defined as one-time costs in either |
| the year prior to or the first year after the start of the Draft Contract. |
| 5) Expenditures entered in this form should be in addition to that of typical annual capital investments and operating expenses |
| of the first year of the Draft Contract. |
6) Expenditures entered into this form should not be included in the proforma income statement.
| 7) Expenditures entered in this form should be included in the cash flow proforma as capital expenditures in either the year prior |
| to or the first year after the start of the Draft Contract. |
| Definitions |
| Start-up Expenses |
| One-time expenses incurred prior to the beginning of the contract, or during the first year of the contract, if needed, to implement |
| your proposal. |
| Working Capital |
| Additional funds for working capital current assets such as pre-paid expenses, contingencies, and other necessary cash flow |
| requirements. This should not be confused with Net Working Capital (current assets-current liabilities). |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X&K000000
Investments Assumptions
INITIAL INVESTMENTS AND START-UP EXPENSES ASSUMPTIONS
Grey Cells Are Input Cells
Name of Offeror
CONCID BLRI002-27
| Assets |
| Existing Assets |
| Assets necessary to the operation of the Concession already owned by the Offeror that will be allocated to the operation |
| of the Draft Contract. |
| Real Property (not within the Park) | Describe |
| Personal Property | Describe |
| Inventory and Supplies | Describe |
| Other (describe) | Describe |
| Planned Asset Acquisition |
| Assets necessary to Operate the Concession that will be acquired by the Offeror if awarded the Draft Contract. |
| Real Property (not within the Park) | Describe |
| Personal Property | Describe |
| Inventory and Supplies | Describe |
| Other (describe) | Describe |
| Other | |
| Deferred Maintenance | |
| Start-Up Expenses | Describe |
| Working Capital | Describe |
| Other (describe) | Describe |
| Notes |
| 1) In the description sections of this form, please provide an explanation of sufficient detail to allow a reviewer to fully |
| understand how the estimates were determined. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Income Statement Form
INCOME STATEMENT FORM
| Grey Cells Are Input Cells |
| Name of Offeror |
CONCID BLRI002-27
Prospective Income Statement
2027 2028 2029 2030 2031 2032 2033 2034 2035 2036
| Revenue | ||||||||||
| Retail | ||||||||||
| Northwest Trading Post | ||||||||||
| Total Retail Revenue | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Food and Beverage | ||||||||||
| (Authorized Service-Not Required) | ||||||||||
| Total Food & Beverage Revenue | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other | ||||||||||
| Other (Specify) | ||||||||||
| Total Other Revenue | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Total Gross Revenue | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Total Deductions | ||||||||||
| Total Gross Receipts | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Cost of Sales |
| Retail |
| Food and Beverage |
| Other |
Total Cost of Sales $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Gross Profit $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Direct Expenses
| Retail | ||||||||||
| Salaries and Wages | ||||||||||
| Payroll Taxes and Benefits | ||||||||||
| Other Departmental Expenses | ||||||||||
| Total Retail Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Food and Beverage | ||||||||||
| Salaries and Wages | ||||||||||
| Payroll Taxes and Benefits | ||||||||||
| Other Departmental Expenses | ||||||||||
| Total Food and Beverage Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Departmental Expenses (Specify) | ||||||||||
| Salaries and Wages | ||||||||||
| Payroll Taxes and Benefits | ||||||||||
| Other Departmental Expenses | ||||||||||
| Total Other Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
Total Direct Expenses $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Undistributed Expenses |
| Other Salaries |
| Utilities |
| Repair and Maintenance Expense |
| Office Supplies |
| Telecommunications (Telephone/Internet, etc) |
| Management / Overhead |
| Advertising |
| Other Admin |
| Other Undistributed |
Total Undistributed Expenses $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Fixed Expenses |
| Insurance |
| Property Taxes |
| Property Rental |
| Other (Specify) |
Total Fixed Expenses $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Total Operating Expenses $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
EBITDA Before FF $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Franchise Fee
EBITDA $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Interest Expense |
| Depreciation |
| Amortization |
Net Profit Before Taxes $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Income Tax
Net Income $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Notes |
| 1) Formulas included in this form are provided by the NPS as guidance only. The Offeror is responsible for its financial projections and their accuracy. |
2) Yellow cells represent categories that need to be explained on the "Income Statement Assumptions" worksheet.
| 3) Only projected receipts and expenses related to the services “required” by the contract and those you choose to operate under “authorized” services are to be itemized and included in |
| your prospective statements. Please clearly identify, by service type, all revenues associated with authorized services. |
| 4) The NPS views the treatment of Repair and Maintenance Reserve (component renewal) items as leasehold improvements. It is expected that the cost will be amortized over the shorter of |
| the useful life of the asset or the contract term. |
| Definitions |
| Gross Receipts |
| Gross Revenues less any revenues that are exempt from franchise fee. |
| EBITDA Before FF |
| Earnings Before Interest, Taxes, Depreciation, Amortization, and Franchise Fee. |
| Franchise Fee |
| A percentage of gross receipts due to the National Park Service. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Income Statement Assumptions
| INCOME STATEMENT ASSUMPTIONS |
| Grey Cells Are Input Cells |
| Name of Offeror |
CONCID BLRI002-27
| Revenue |
| See Operating Assumptions Tab |
| Cost of Sales (Provide for Each Department) | |
| All Applicable Departments | |
| Describe | |
| Direct Expenses (Provide for Each Department) | |
| Labor - Salaries & Wages | Describe |
| Payroll Taxes & Benefits | Describe |
| Other Departmental Expenses | Describe |
| Undistributed Expenses | |
| Other Salaries | Describe |
| Utilities | Describe |
| Repair & Maintenance | Describe |
| Office Supplies | Describe |
| Telecommunications (Phone/Internet, etc.) | Describe |
| Management Fee / Overhead | Describe |
| Advertising | Describe |
| Vehicle Expense | |
| Other Admin | Describe |
| Other Undistributed | Describe |
| Fixed Expenses | |
| Insurance | Describe |
| Property Taxes | Describe |
| Property Rental | Describe |
| Other | Describe |
| Notes | |
| 1) In the description sections of this form, please provide an explanation of sufficient detail to allow a reviewer to fully | |
| understand how the estimates were determined. |
| 2) If you are going to offer authorized services, please clearly identify which service(s) you will offer and use additional |
| separate rows for each authorized service department. Labor costs should be supported by a footnote identifying Full |
| Time Equivalents (FTE) occupied for each operating department identified. |
| 3) Clearly describe the composition of each item classified under Undistributed and Fixed Expenses. If the expense item |
| is allocated from or shared with a parent or related entity, please describe the allocation method. In particular, if you |
| intend to assess a Management Fee, or other form of corporate overhead and profit, you must clearly describe what this |
| fee is comprised of (Officer salaries, human resources, accounting, marketing, profit, etc.). |
| Expense Assumption Description Example |
| ***The following example does not reflect the above opportunity and is provided for the purpose of clarification only.*** |
| Direct expenses are expected to surpass historical direct expenses, as fuel and insurance prices increase. Studies by |
| the Department of Commerce indicate that fuel prices will to rise at a rate of 10% annually over the next ten years, as |
| opposed to the historical ten year rate of 4% annually. Additionally, insurance costs, according to a nationwide |
| insurance broker survey, are expected to rise at 15% annually for the next 10 years, as opposed to the 10 year historical |
| rate of 2% annually. Accordingly, direct expenses associated with the operation are forecast to increase from an annual |
| average of 10% of Gross Revenue to an annual average of 20% of Gross Revenues over the life of the Draft Contract. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Operating Assumptions Form
OPERATING ASSUMPTIONS
| Grey Cells Are Input Cells |
| Name of Offeror |
CONCID BLRI002-27
2027 2028 2029 2030 2031 2032 2033 2034 2035 2036
| Revenue Inflation | Additional Description |
| Expense Inflation |
| Retail | |
| Northwest Trading Post | |
| Total Transactions | Additional Description |
| Average Revenue Per Transaction | |
| Retail Revenue |
TOTAL RETAIL REVENUE $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Food and Beverage | |||||||||||
| (Authorized-Not Required) | |||||||||||
| Total Covers | Additional Description | ||||||||||
| Average Check | |||||||||||
| Food and Beverage Revenue | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
TOTAL FOOD & BEVERAGE REVENUE $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Notes |
| 1) Please note that revenue projections must be based on rates determined by the approval methods set forth in the draft Operating Plan. |
| 2) The information on this form should fully explain and document your Gross Revenue build-up. State annual inflation rate assumptions, rate increase assumptions, utilization assumptions and any estimates of real |
| growth you anticipate. If you have any additional descriptions of your assumptions, please use the "Additional Description" boxes to the right of each revenue department. |
3) If you are going to offer authorized services, please clearly identify which service(s) you will offer and use additional rows to describe your revenue buildup for each authorized service.
| Revenue Assumption Description Example |
| ***The following example does not reflect the above opportunity and is provided for the purpose of clarification only.*** |
| Revenue inflation is expected increase at the same rate as the Consumer Price Index which is predicted to grow at a rate of 2.7% annually, based upon historical growth as reported by the Bureau of Labor Statistics |
| No real growth is expected to occur, keeping in line with historical revenues at the concession. Therefore, overall revenue growth is forecast to occur at an average annual rate of 2.7% over the life of the Draft Contract. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic"PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Cash Flow Statement Form
| CASH FLOW STATEMENT FORM |
| Grey Cells Are Input Cells |
| Name of Offeror |
| CONCID | BLRI002-27 |
| Prospective Cash Flow Statement |
| Operating Activities | Year Zero | 2027 | 2028 | 2029 | 2030 | 2031 | 2032 | 2033 | 2034 | 2035 | 2036 |
| Net Income | |||||||||||
| Depreciation | |||||||||||
| Amortization | |||||||||||
| Other (describe) |
Net Cash Provided (Used) by Operating Activities $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Financing Activities |
| Dividend |
| Sale/Repurchase of Stock |
| Borrowings/ Repayment of Debt |
| Other (describe) |
Net Cash Provided (Used) by Financing Activities $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Investment Activities | |
| Leasehold Surrender Interest | $0 |
| Component Renewal Reserve | |
| Personal Property Replacement | |
| Deferred Maintenance | |
| Real Property (not Within Park) | |
| Inventory and Supplies | |
| Start-Up Expenses | |
| Working Capital | |
| Other (describe) | |
| Other (describe) | |
| Other (describe) |
Net Cash Provided (Used) by Investing Activities $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
Total Cash Flow $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
| Notes |
| 1) Formulas included in this form are provided by the NPS as guidance only. The Offeror is responsible for its financial projections and their accuracy. |
2) Yellow cells represent categories that need to be explained on the "Cash Flow Statement Assumptions" worksheet.
3) Investment activities should include entries for one time acquisition and disposal at the beginning and end of the Draft Contract term as well as cyclical or annual capital investments such as replacement.
| 4) Estimates for capital expenditures in the Cash Flow Statements made prior to or during the first year after the start of the Draft Contract should be reflective of estimates provide in the Initial Investment |
| and Start-up Costs form. |
5) Clearly delineate between personal and real property and define your rationale and assumptions for each category.
6) Since Repair and Maintenance Reserve (component renewal) activities are considered capital expenditures they should be included on the cash flow statement.
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Cash Flow Statement Assumptions
| CASH FLOW STATEMENT ASSUMPTIONS |
| Grey Cells Are Input Cells |
| Name of Offeror |
| CONCID | BLRI002-27 |
| Investment Activities | |
| Leasehold Surrender Interest | Describe - LSI occurring during the Draft Contract |
| Component Renewal Reserve | Describe - Component Renewal Reserve expenditures during the Draft Contract |
| Personal Property Replacement | Describe - Personal property replacement during the Draft Contract |
| Deferred Maintenance | Describe |
| Other (describe) | Describe |
| Notes | |
| 1) In the description sections of this form, please provide an explanation of sufficient detail to allow a reviewer to fully | |
| understand how the estimates were determined. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Recapture of Investment Form
RECAPTURE OF INVESTMENT FORM
Grey Cells Are Input Cells
Name of Offeror
CONCID BLRI002-27
Assets and Other
| Leasehold Surrender Interest Value |
| Real Property (not within the Park) |
| Personal Property |
| Inventory and Supplies |
| Working Capital |
| Fixtures LSI Recovery |
| Other (describe) |
| Other (describe) |
Total of Recapture of Investments at the End of the Contract Term $0
| Notes |
| 1) The value of ending LSI is only a best guess estimate neither offeror nor the NPS is bound by the number presented above. |
2) Reference the Draft Contract and exhibits for guidance on Leasehold Surrender Interest and Personal Property.
| 3) Formulas included in this form are provided by the NPS as guidance only. The Offeror is responsible for its financial |
| projections and their accuracy. |
4) Yellow cells represent categories that need to be explained on the "Recapture of Investment Assumptions" worksheet.
5) All Offerors must include their estimate of the ending value of all property and other assets at the end of the Draft Contract.
6) Recapture amounts entered into this form should not be included in the proforma income statement.
| 7) Recapture amounts entered in this form should be included in the cash flow proforma as capital recapture in the final year |
| of the Draft Contract. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X&K000000
Recapture of Inv Assumptions
RECAPTURE OF INVESTMENT ASSUMPTIONS
Grey Cells Are Input Cells
Name of Offeror
CONCID BLRI002-27
| Assets and Other |
| Please describe the method used to determine the values of the planned recoup of investments at the end of the |
| Draft Contract. |
| Leasehold Surrender Interest Value | Describe |
| Real Property (not within the Park) | Describe |
| Personal Property | Describe |
| Inventory and Supplies | Describe |
| Working Capital | Describe |
| Other (describe) | Describe |
| Other (describe) | Describe |
| Other (describe) | Describe |
| Notes |
| 1) In the description sections of this form, please provide an explanation of sufficient detail to allow a reviewer to |
| fully understand how the estimates were determined. |
&"Times New Roman,Italic"CC-&KFF0000XXXX000-XX &"Times New Roman,Italic" PROPOSAL PACKAGE FORMS &"Times New Roman,Italic"APPENDIX &KFF0000X
Notices
NOTICES
| PRIVACY ACT |
| Authority: 16 U.S.C. 5966, Commercial Use Authorizations. |
Purpose: The purposes of the system are (1) to assist NPS employees in managing the NPS Commercial Services program allowing commercial uses within a unit of the National Park System to ensure that business activities are conducted in a manner that complies with Federal laws and regulations; (2) to monitor resources that are or may be affected by the authorized commercial uses within a unit of the National Park System; (3) to track applicants and holders of commercial use authorizations who are planning to conduct or are conducting business within units of the National Park System; and (4) to provide to the public the description and contact information for businesses that provide services in national parks.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act, records or information contained in this system may be disclosed outside DOI as a routine use pursuant to 5 U.S.C. 552a(b)(3) to other Federal, state and local governments, tribal organizations, and members of the general public upon request for names, addresses and phone numbers of Commercial Use Authorizations (CUA) holders conducting business within units of the National Park System for the purpose of informing the public of the availability of the services offered by the CUA holder. In addition, records or information contained in this system may be disclosed outside DOI based on an authorized routine use when the disclosure is compatible with the purpose for which the records were compiled as described under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to 1) manage the National Park Service (NPS) Commercial Services Program allowing commercial uses within a unit of the NPS, 2) monitor resources that are or may be affected by the authorized commercial uses, and 3) provide the public the description and contact information for businesses that provide services in national parks.
| PAPERWORK REDUCTION ACT STATEMENT |
| We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998 (Pub. L. 105–391). We use this information to evaluate a concession proposal. Your response is required to obtain or retain a benefit. Your response is required to obtain or retain a benefit. We may not collect or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1024-0029. |
| ESTIMATED BURDEN STATEMENT |
| We estimate that it will take you 10 hours to complete this form, including time to review instructions, gather and maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 12201 Sunrise Valley Drive, Mail Stop 242, Reston, VA 20192. Please do not send your completed form to this address. |
&"Times New Roman,Regular"&8NPS Form 10-359A (Rev. 08/2016) National Park Service &"Times New Roman,Regular"&8OMB Control No. 1024-0029 Expiration Date ##/##/####
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