36C25018Q9377-013.xlsx

XLSX spreadsheet 14 KB Posted

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Patient Travel - Ann Arbor
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36C25018Q9377
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36C25018Q9377 Attachment IX - Price_Cost Worksheet.xlsx

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Sheet1 Beneficiary Travel - Ann Arbor VA Healthcare System SMT Wheelchair (W.C.) Van and Common Carrier (C.C)

Year 1
Description of Cost Elements
CLINSDescriptionEstimated UnitsUnit of MeasureCost Per UnitExtended Cost
0001C.C Base Rate950EA (Trip)$ - 0
0002C. C Mileage rate over 30 Mile Base30,000EA (Mile)$ - 0
0003C.C. Wait time billed in .25 hours70HR$ - 0
0004C.C. Cancel Fee70EA$ - 0
0005W.C. Base Rate4,240EA (Trip)$ - 0
0006W.C. Milage rate over 30 mile Base120,000EA (Mile)$ - 0
0007W.C. Cancel Fee50EA$ - 0
0008W.C. Wait time billed in .25 hours150HR$ - 0
Total Estimated Value (YEAR 1)$ - 0
Year 2
Description of Cost Elements
CLINSDescriptionEstimated UnitsUnit of MeasureCost Per UnitExtended Cost
1001C.C Base Rate950EA (Trip)$ - 0
1002C. C Mileage rate over 30 Mile Base30,000EA (Mile)$ - 0
1003C.C. Wait time billed in .25 hours70HR$ - 0
1004C.C. Cancel Fee70EA$ - 0
1005W.C. Base Rate4,240EA (Trip)$ - 0
1006W.C. Milage rate over 30 mile Base120,000EA (Mile)$ - 0
1007W.C. Cancel Fee50EA$ - 0
1008W.C. Wait time billed in .25 hours150HR$ - 0
Total Estimated Value (YEAR 2)$ - 0
Year 3
Description of Cost Elements
CLINSDescriptionEstimated UnitsUnit of MeasureCost Per UnitExtended Cost
2001C.C Base Rate950EA (Trip)$ - 0
2002C. C Mileage rate over 30 Mile Base30,000EA (Mile)$ - 0
2003C.C. Wait time billed in .25 hours70HR$ - 0
2004C.C. Cancel Fee70EA$ - 0
2005W.C. Base Rate4,240EA (Trip)$ - 0
2006W.C. Milage rate over 30 mile Base120,000EA (Mile)$ - 0
2007W.C. Cancel Fee50EA$ - 0
2008W.C. Wait time billed in .25 hours150HR$ - 0
Total Estimated Value (YEAR 3)$ - 0
Year 4
Description of Cost Elements
CLINSDescriptionEstimated UnitsUnit of MeasureCost Per UnitExtended Cost
3001C.C Base Rate950EA (Trip)$ - 0
3002C. C Mileage rate over 30 Mile Base30,000EA (Mile)$ - 0
3003C.C. Wait time billed in .25 hours70HR$ - 0
3004C.C. Cancel Fee70EA$ - 0
3005W.C. Base Rate4,240EA (Trip)$ - 0
3006W.C. Milage rate over 30 mile Base120,000EA (Mile)$ - 0
3007W.C. Cancel Fee50EA$ - 0
3008W.C. Wait time billed in .25 hours150HR$ - 0
Total Estimated Value (YEAR 4)$ - 0
Year 5
Description of Cost Elements
CLINSDescriptionEstimated UnitsUnit of MeasureCost Per UnitExtended Cost
4001C.C Base Rate950EA (Trip)$ - 0
4002C. C Mileage rate over 30 Mile Base30,000EA (Mile)$ - 0
4003C.C. Wait time billed in .25 hours70HR$ - 0
4004C.C. Cancel Fee70EA$ - 0
4005W.C. Base Rate4,240EA (Trip)$ - 0
4006W.C. Milage rate over 30 mile Base120,000EA (Mile)$ - 0
4007W.C. Cancel Fee50EA$ - 0
4008W.C. Wait time billed in .25 hours150HR$ - 0
Total Estimated Value (YEAR 5)$ - 0

TOTAL ESTIMATED CONTRACT VALUE $ - 0

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