J.42 CLIN 0009 Cost Proposal Template - Outgoing Contractor Workload Transition Activities.xlsx
XLSX spreadsheet 23 KB Posted
- Solicitation number
- 75FCMC19R0041
About this file
This document includes a cost proposal template and related files for a Centers for Medicare and Medicaid Services solicitation for Durable Medical Equipment Medicare Administrative Contractor services in Jurisdiction C. The template provides instructions and categories for offerors to submit pricing for workload transition activities under Contract Line Item Number 0009, including direct labor costs by labor category, fringe benefits, travel expenses, subcontractor costs, other direct costs, and indirect costs. The related federal contract opportunity notice identifies the requirement as providing Medicare claims processing and payment services for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, Puerto Rico, and the U.S. Virgin Islands. Offerors are to use the template and guidelines provided to submit pricing proposals for the transition of the incumbent contractor's workload under this Centers for Medicare and Medicaid Services solicitation for Durable Medical Equipment Medicare Administrative Contractor services in Jurisdiction C.
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Text version
CLIN-0009
| COST TEMPLATE - Attachment J.42 | |||||||||
| (Provide a cost spreadsheet for each CLIN proposed) | |||||||||
| CLIN 0009 - Outgoing Contractor Workload Transition Activities Closeout | C.5.2 | I | |||||||
| DME 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 |
201918
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DME MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
Confidential Procurement Sensitive &P
ODC Schedule
| ODC SCHEDULE - Attachment J.42 | |
| (Provide an ODC Spreadsheet for each CLIN Proposed) | |
| CLIN 0009 DME SERVICES | |
| Cost Element | TOTAL |
Add costs by category
TOTAL ODCs $0.00
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DME MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
TRAVEL
| Attachment J.42 |
| TRAVEL SUMMARY |
| CLIN 0009 |
| 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 75FCMC19R0041
DME MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
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