The file's text, extracted by GovTribe without its formatting.
Instructions
| Cost Template Instructions |
| 1 | Please Read instructions in solicitation. |
| 2 | The following worksheets are formula driven requiring no input except for adding offeror name: |
| CLIN Summary |
| Baseline Services |
| Sub Baseline Services |
| 3 | Quoter to provide payrates and markup by labor category on following worksheets: |
| Baseline Labor Rate Buildup |
| 4 | Quoter's Sub to provide payrates and markup by labor category on following worksheets: |
| Sub Baseline Labor Rate Buildup |
| NOTE: Add additional worksheets for additional Subs as necessary and adjust other worksheets to accommodate changes. |
| 6 | Quoter to provide the prices for all the mandatory fee for service items and include any additional fee for service items that will be offered along with the price |
| Mandatory FFS |
| NOTE: They may be sample data on worksheets that needs to be removed. |
CLIN Summary
| CLIN SUMMARY |
| OHSS III |
| CLIN Summary |
| CLIN | Description | Base Period | Option Period 1 | Option Period 2 | Option Period 3 | Total |
| CLIN 0001 | Baseline Services | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| CLIN 0002 | Other Direct costs (ODC) CR no fee | $ 38,051 | $ 19,749 | $ 20,256 | $ 20,782 | $ 98,838 |
| Total | | $ 38,051 | $ 19,749 | $ 20,256 | $ 20,782 | $ 98,838 |
| All data flows from other worksheets. Confirm accuracy of formulas. |
| Yellow Highlighted numbers are government provided, do not change. |
Baseline Services
Quoter: _________________________________________________
| Year 1 | | | Year 2 | | | Base Period | | Option Period 1 -Year 3 | | | Option Period 2 -Year 4 | | | Option Period 3 -Year 5 | | | Total | |
| Labor category | Hours | Rate | Cost | Hours | Rate | Cost | | | Hours | Rate | Cost | Hours | Rate | Cost | Hours | Rate | Cost | Hours | Cost |
| labor cat 1 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 2 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 3 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 4 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 5 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 6 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 7 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 8 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 9 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 10 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 11 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 12 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 13 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 14 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 15 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| Subtotal Labor | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 |
| Sub | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 |
| Total | 0 | $ - 0 | | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 |
| travel/training | | | | | | | | | | | | | | |
All data flows from other worksheets
All data flows from other worksheets. Confirm accuracy of formulas.
Baseline Labor Rate Buildup
| Quoter: _________________________________________________ | | | | | | |
| Year 1 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 2 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 3 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 4 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 5 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
Sub Baseline Services
Quoter: _________________________________________________
| Year 1 | | | Year 2 | | | Base Period | | Option Period 1 -Year 3 | | | Option Period 2 -Year 4 | | | Option Period 3 -Year 5 | | | Total | |
| Labor category | Hours | Rate | Cost | Hours | Rate | Cost | | | Hours | Rate | Cost | Hours | Rate | Cost | Hours | Rate | Cost | Hours | Cost |
| labor cat 1 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 2 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 3 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 4 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 5 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 6 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 7 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 8 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 9 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 10 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 11 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 12 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 13 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 14 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| labor cat 15 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | - 0 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $0.00 | $ - 0 | 0 | $ - 0 |
| Total Sub | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 | 0 | $ - 0 |
| All data flows from other worksheets | | | | | | | | | | | | | | |
All data flows from other worksheets. Confirm accuracy of formulas.
Sub Baseline Labor Rate Buildup
| Quoter: _________________________________________________ | | | | | | |
| Year 1 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 2 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 3 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 4 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
| Year 5 | | | | | | |
| Labor Category | Hours Per Labor Category | Direct Labor Rate | Markup | Bill Rate Includes Fee | WD or Exempt | Source for Pay Rate |
| labor cat 1 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 2 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 3 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 4 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 5 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 6 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 7 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 8 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 9 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 10 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 11 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 12 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 13 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 14 | 0 | $0.00 | $0.00 | $0.00 |
| labor cat 15 | 0 | $0.00 | $0.00 | $0.00 |
Mandatory FFS Mandatory Fee-for-Services for LaRC Contractors and Civil Servant Retirees (*Note: the PWS paragraph references below are to describe the services to be offered. Although the PWS paragraphs may say “at no cost to employee,” that is only referring to Civil Servants and LaRC Exchange Personnel.
| Contract Year 1 Price (each) | Contract Year 2 Price (each) | Contract Year 3 Price (each) | Contract Year 4 Price (each) | Contract Year 5 Price (each) |
| Occupation-Related Examination: Pre-Placement (PWS Section 1.6.4) | | | | |
| Occupation-Related Examination: Surveillance (PWS Section 1.6.4) | | | | |
| Occupation-Related Examination: Job Certification/ Special Purpose (PWS Section 1.6.4) | | | | |
| Occupation-Related Examination: Job Separation/ Retirement (PWS Section 1.6.4) | | | | |
| Occupation-Related Examination: Flight Physical Examinations IAW NASA Aviation Medical Certification Standards (PWS Section 1.6.4) | | | | |
| Optician Services (PWS Section 1.6.9) | | | | |
| International Travel: Pre‐travel physical assessment, counseling, required immunizations, travel kits (PWS Section 1.6.4) | | | | |
| Hepatitis A and B Vaccination (PWS Section 1.7.1) | | | | |
| Tetanus Vaccination (PWS Section 1.7.1) | | | | |
| TDAP Vaccination (PWS Section 1.7.1) | | | | |
| Mandatory Fee-for-Services for All Employees - This includes LaRC Civil Service employees, LaRC Exchange employees, LaRC Contractors, and LaRC Civil Service Retirees | | | | |
| Non-Work-Related Injury/Illness Office Visit (PWS Section 1.6.3) |
| Administration of Medicines and Treatment (PWS Section 1) |
| EAP Counseling Session per Hour* (PWS Section 2.0) |
* As noted in PWS 2.0, LaRC Civil Service employees, LaRC Exchange employees, and their families incur no cost for up to 5 sessions per concern. This FFS pricing listed here only applies to LaRC Civil Service employees, Exchange employees and their families for any sessions beyond the first 5 sessions per concern. For LaRC contractors the counseling session per hour price applies to initial and all other sessions.
| Head-to-Toe Complete Health Maintenance Examination (PWS Section 8) |
| Partial Health Maintenance Examination (PWS Section 8) |