9. Appendix G - Driver Invoice.pdf
PDF 80 KB Posted
- Attached to
- 12-7811-Supplemental Driver
- Solicitation number
- 6100056346-B-2
- Issued by
- Adams County, Pennsylvania
About this file
The document provided is an Appendix G - Driver Invoice related to a state and local contract opportunity issued by the Pennsylvania Department of Labor & Industry (L&I) for the Office of Vocational Rehabilitation (OVR) to provide Non-Emergency Transport Services in Adams, Cumberland, Dauphin, Franklin, Lancaster, Lebanon, Perry, and York Counties. The contract term is anticipated to begin upon approval through June 30, 2023. L&I is seeking drivers with experience providing these services and is issuing this as a Supplemental Invitation for Bid (IFB) to contract 6100056119. This is a Small Business/Small Diverse Business Solicitation, and all responsive bidders will receive a contract, though an award does not guarantee assignment of work.
Bidders must submit their price for Non-Emergency Transport Ambulatory Services and Non-Emergency Transport Non-Ambulatory Services, not to exceed the capped hourly rates identified in Appendix E. Bidders must also bid $1.00 each for travel, food, and lodging expenses. The bids are due November 18, 2022, at 8:00 a.m., and late bids will be disqualified. Current suppliers with valid contracts are not eligible to apply to this solicitation.
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Text version
OVR-141
11/18
DRIVER INVOICE # ___
Service Provider Address: P.O. Number ______________________ (Please use address in SAP)
Name
Street Address
Services Provided to _____________________ OVR Employee Name
City, State, Zip OVR District Office _______________________________
Phone
SAP Vendor # _
Service Dates from ____ to ______
(1st date) (last date)
Description Units
Unit Price Total Price
Transport Service/Hours
(total hours) (your P.O. hourly rate)
Travel Expenses: mileage, tolls, parking, meals, and lodging
$1.00 each
Note: Time (total hours) must be calculated in increments of 15 minutes, i.e. 1 hour 15 minutes would be 1.25
Total Due
Driver's Signature Date
Verified by OVR Employee Date
If applicable, additional documentation such as log sheet and receipts will be attached to this invoice as required.
File details come from the government source that posted it. Updated .