5-Appendix C Cost Response Form.docx

This is a Cost Response Form (Appendix C) for an Audit Services Request for Proposal issued by the New Mexico Health Care Authority (Department). The form serves as the pricing submission document for Independent Public Accountants (IPAs) seeking to contract with the Department to perform annual audits of the Department's financial statements. Offerors must submit a total cost per state fiscal year for implementation of their service, with costs inclusive of all specifications related to Random Moment Surveys, Administrative Claiming, and Direct Medical Service Cost Reporting and Settlement activities. The evaluation of proposals will be based on the total cost of implementation.

Qualified offerors must be in good standing with the Office of the State Auditor and must perform the audit in accordance with State Auditor Rule (2.2.2 NMAC), generally accepted auditing standards (GAAS), and the Uniform Grant Guidance regulations under OMB's Super Circular (2 CFR 200-521). The Cost Response Form requires the firm name, signature of an authorized representative, and the date of submission but does not specify pricing structures, set-asides, or other detailed financial terms within this particular document. Contract award and term information are not addressed in this appendix.