36C24419Q0225-0002002.docx
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- 36C24419Q0225
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36C24419Q0225 0002 BFS Schedule Updated 1-23-19.docx
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B.4 PRICE/COST SCHEDULE (Offeror shall complete all fillable information below)
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
5 Year Estimated Total (Estimated 12 Month Cost x 5)
| 0001 |
| Bereavement Family Survey Services in accordance with the Performance Work Statement |
| 60.00 |
| MONTHS |
ESTIMATED 12 MONTH COST (COST PER INPATIENT DEATH (20,000 EA)) + (COST PER HOME BASED PRIMARY CARE DEATH (4,000 EA)): $____________
COST PER EACH INPATIENT DEATH: $____________
COST PER EACH HOME BASED PRIMARY CARE DEATH: $____________
*Note – A “Death” shall intel all of the following: sending out one survey and if it’s returned to include all data processing, if it’s not returned within 30 days a second reminder survey will be sent out, which could result in never getting a response, but if the reminder survey is returned, it would include all data processing.
*Note 2 – Inpatient and Home Based Primary Care Death quantities are estimates only.
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