22R0070_Attachment 1_Pricing.xlsx
XLSX spreadsheet 20 KB Posted
- Solicitation number
- 19GE5022R0070
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Other files
| File | Type | Posted |
|---|---|---|
| 19GE5022P00002.pdf | ||
| 22Q0070 Questions and Answers.pdf | ||
| Last Five Years.xlsx | XLSX spreadsheet | |
| Personnel Numbers.xlsx | XLSX spreadsheet | |
| 19GE5022R0070_P0001.pdf | ||
| 22R0070_RFP Cover Letter_Signed.pdf | ||
| 19GE5022R0052_Exhibit A.pdf | ||
| 22R0070_Attachment 2_ Experience and Past Performance.docx | DOCX document | |
| Attachment 3 - Form W-14.pdf | ||
| 19GE5022R0070.pdf |
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Text version
Pricing Schedule
| 001 BASE YEAR | |||
| Sub CLIN | Estimated Number of Employees | Monthly Premium | Total |
| 001a Employee | 196 | - 0 | |
| 001b Employee's Spouse | 163 | - 0 | |
| 001c Employee's Dependent Children | 573 | - 0 |
e.Subtotal (a+b+c) - 0 f.Total Price for Base Year (e x 12 Months ) - 0
| 1001 OPTION YEAR ONE | |||
| Sub CLIN | Estimated Number of Employees | Monthly Premium | Total |
| 1001a Employee | 196 | - 0 | - 0 |
| 1001b Employee's Spouse | 163 | - 0 | - 0 |
| 1001c Employee's Dependent Children | 573 | - 0 | - 0 |
e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR ONE (e x 12 Months ) - 0
| 2001 OPTION YEAR TWO | |||
| Sub CLIN | Estimated Number of Employees | Monthly Premium | Total |
| 2001a Employee | 196 | - 0 | - 0 |
| 2001b Employee's Spouse | 163 | - 0 | - 0 |
| 2001c Employee's Dependent Children | 573 | - 0 | - 0 |
e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR TWO (e x 12 Months ) - 0
| 3001 OPTION YEAR THREE | |||
| Sub CLIN | Estimated Number of Employees | Monthly Premium | Total |
| 3001a Employee | 196 | - 0 | - 0 |
| 3001b Employee's Spouse | 163 | - 0 | - 0 |
| 3001c Employee's Dependent Children | 573 | - 0 | - 0 |
e.subtotal (a+b+c) - 0 f.Total Price for OPTION YEAR THREE (e x 12 Months ) - 0
| 4001 OPTION YEAR FOUR | |||
| Sub CLIN | Estimated Number of Employees | Monthly Premium | Total |
| 4001a Employee | 196 | - 0 | - 0 |
| 4001b Employee's Spouse | 163 | - 0 | - 0 |
| 4001c Employee's Dependent Children | 573 | - 0 | - 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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