J.49 CLIN 0016 Cost Proposal Template - Outgoing Contractor Workload Transition Activities.xlsx
XLSX spreadsheet 23 KB Posted
- Solicitation number
- 75FCMC19R0023
About this file
This document outlines a federal contract opportunity for Medicare Administrative Contractor services in Jurisdiction E. The Centers for Medicare and Medicaid Services intends to issue a request for proposal to obtain a contractor to provide Medicare claims processing and payment services for California, Hawaii, Nevada, American Samoa, Guam, and the Northern Mariana Islands. Services will include claims-related activities, provider relationships, and ensuring financial integrity of the Medicare Fee-For-Service Program. The anticipated proposal due date is November 4, 2019, with an award date of August 4, 2020. The contract will have a one-year base period and six one-year options. Award will be made using a best value tradeoff process considering cost and technical factors.
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Text version
CLIN-0016
| COST TEMPLATE - Attachment J.49 | |||||||||
| (Provide a cost spreadsheet for each CLIN proposed) | |||||||||
| CLIN 0016 - Outgoing Contractor Workload Transition Activities Closeout | C.5.2 | I | |||||||
| A/B SERVICES | Total FTEs | Workload Closeout Project Plan | AWARD FEE | GRAND TOTAL | |||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Total | ||
| COST ELEMENTS |
| Direct Labor | |||||
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| Add Other Appropriate Labor Categories (note: labor categories should match WBS) | 0 | $0.00 | $0 | 0 | $0.00 |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| Subtotal Direct Labor | 0 | $0 | 0 | $0.00 |
Fringe Benefits (at ____%) $0 $0.00
Total Direct Labor $0 $0.00
| Travel (see separate schedule) | $0 | $0.00 | ||
| SUBCONTRACTORS | ||||
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Total Subcontractor | 0 | $0 | 0 | $0.00 |
Other Direct Costs (See separate schedule) $0 $0.00
TOTAL ALL DIRECT COSTS $0 $0.00
Indirect Costs (at ______ %) $0 $0.00
TOTAL OTHER BEFORE FEE $0 $0.00
| Base Fee (at ____%) | $0 | $0.00 | |
| Award Fee (at ______%) | $0 | $0.00 | |
| Fixed Fee (at ______%) | $0 | $0.00 |
TOTAL OTHER AFTER FEE $0 $0 $0.00
| Complementary Credits | |||
| Note: comp. credit information will be provided by CMS prior to final proposal revision. Offerors should not propose amounts at this time. | |||
| GRAND TOTAL | $0 | $0 | $0.00 |
20180208
&"Arial,Bold"&12 75FCMC19R0023
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
Confidential Procurement Sensitive &P
ODC Schedule
| ODC SCHEDULE - Attachment J.49 | |
| (Provide an ODC Spreadsheet for each CLIN Proposed) | |
| CLIN 0016 A/B SERVICES | |
| Cost Element | TOTAL |
Add costs by category
TOTAL ODCs $0.00
&"Arial,Bold"&12 75FCMC19R0023
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
TRAVEL
| Attachment J.49 |
| TRAVEL SUMMARY |
| CLIN 0016 |
| Purpose of Trip | SOW WBS | |||
| Crosswalk | Labor Category Taking Trip | Trip Origin | Destination | # People |
| (A) | # Trips | |||
| (B) | # Days | |||
| (C) | # Nights | |||
| (D) | Lodging Rate | |||
| (E) | Lodging | |||
| (F=E*D*A) | M&IE | |||
| (G) | Total Lodging |
and M&IE
| (H=F+G) | Airfare |
| (I) | Car Rental |
| (J) | Misc |
| (K) | Local |
Mileage
| (L) | Total Per Trip |
| (M=H+I+J+K+L) | Total For All Trips |
(N=M*B )
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
TOTAL TRAVEL $ -
Travel Assumptions:
&"Arial,Bold"&12 75FCMC19R0023
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
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