J.44 CLIN 0011 Cost Proposal Template - Base Year (MPIP).xlsx
XLSX spreadsheet 30 KB Posted
- Solicitation number
- 75FCMC19R0041
About this file
This document contains templates for a cost proposal in response to a solicitation for Durable Medical Equipment Medicare Administrative Contractor services. The templates require pricing details for various cost elements including direct labor, fringe benefits, travel, subcontractors, other direct costs, and indirect costs for each Contract Line Item Number proposed. The travel template specifies details required for estimating trip costs including purpose, origin, destination, number of travelers, trips, days, lodging rates, per diem, airfare, rental car, and other expenses. A separate template is provided for other direct costs.
The related federal contract opportunity is for Durable Medical Equipment Medicare Administrative Contractor services to administer Medicare claims processing and payment services for Jurisdiction C, covering 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. The solicitation is issued by the Centers for Medicare and Medicaid Services for an indefinite delivery/indefinite quantity contract.
View the file
Other files
Show 40 more
Latest 50 of 51 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
CLIN 0011
| COST TEMPLATE - Attachment J.44 | |||
| (Provide a cost spreadsheet for each CLIN proposed) | |||
| CLIN 0011 | T.8 | ||
| Total FTEs | Medicare Healthcare Provider Intervention Program (MPIP) | ||
| Hours | Total | ||
| COST ELEMENTS |
| Direct Labor | |||
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| Add Other Appropriate Labor Categories (note: labor categories should match WBS) | 0 | $0.00 | $0.00 |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| 0 | $0.00 | $0.00 | |
| Subtotal Direct Labor | 0 | $0.00 | $0.00 |
Fringe Benefits (at ____%) $0
Total Direct Labor $0
| Travel (See separate schedule. Total should match) | $0 | |
| SUBCONTRACTORS | ||
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Subcontractor Name | 0 | $0.00 |
| Total Subcontractor | 0 | $0.00 |
Other Direct Costs (See separate schedule. Total should match.) $0
TOTAL ALL DIRECT COSTS $0
Indirect Costs (at ______ %) $0
TOTAL OTHER BEFORE FEE $0
| Base Fee (at ____%) | $0 |
| Award Fee (at ______%) | $0 |
| Fixed Fee (at ______%) | $0 |
TOTAL OTHER AFTER FEE $0
| GRAND TOTAL | $0 |
| V2 04242012 |
| 20180524 |
| 20180829 |
| 8/29/19 |
&"Arial,Bold"&12 75FCMC19R0041 DME Medicare Administrative Contractor (MAC)
Confidential, Procurement Sensitive
TRAVEL
| COST TEMPLATE - Attachment J.44 |
| TRAVEL SUMMARY |
| CLIN 0011 |
| 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: |
Confidential, Procurement Sensitive
ODC
COST TEMPLATE - Attachment J.44
| CLIN 0011 DME SERVICES | GRAND | |
| Cost Element | Amount | TOTAL |
| $0.00 | ||
| Add costs by category | $0.00 | |
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| $0.00 | ||
| TOTAL ODCs | $0.00 | $0.00 |
Confidential, Procurement Sensitive
File details come from the government source that posted it. Updated .