Braille Cost Estimate Template 2012 - w Revisions for MSNs and On-Demand
105 KB Posted
- Attached to
- 2 - 5 CMS Publications In Braille
- Solicitation number
- 950-2-3710-06-RAW
About this file
Estimate Template
Text of this file
Sheet1
| Cost Estimate Template | Page 1 | ||||||||||||||||||
| Contractor: | |||||||||||||||||||
| Contract Administrator: | Budget Summary: | Period of Performance: 7/15/2012-7/14/2013 | |||||||||||||||||
| Phone: | FY'05 Allotment $100,000.00 | ||||||||||||||||||
| Fax: | CMS Requisition No. | 402-5-371004 | |||||||||||||||||
| Purchase Order No. | HHSM-500-2005-00144P | ||||||||||||||||||
| Estimated types of products | Funds Remaining | $34,559.00 | |||||||||||||||||
| Task # | Title | Pub. # | Revision Date | ICN # | Ink Page Count | Braille Page Count | Estimated Page Count | Estimated Total QTY Ordered | Estimated QTY to CMS Warehouse | Estimated QTY to Call Center | QTY to Partners | Due-Date | True Expenditure | Paid to Date | Funds Remaining | Invoice # | Estimated QTY to Partners | Estimated QTY of Addresses | Estimated Cost |
| 1 | Medicare & You 2013 | 10050B | September-05 | 004424 | 100 | 225 | 128 | 1550 | 200 | 700 | 650 | 52 | |||||||
| 2 | Choosing a Medigap Policy: 2013 Guide | 02110B | 56 | 550 | 375 | 175 | |||||||||||||
| 3 | Medicare Summary Notices | n/a | 5 | 6000 | 500 | ||||||||||||||
| 4 | CMS Publication TBD | TBD | 2 | 12 | 12 | ||||||||||||||
| 5 | CMS Publication TBD | TBD | 60 | 12 | 12 | ||||||||||||||
| Total Cost | |||||||||||||||||||
| Page 2 | |||||||||||||||||||
| Contractor: | |||||||||||||||||||
| Contract Administrator: | Budget Summary: | Period of Performance: 7/15/2013-7/14/2014 (Option Year 1) | |||||||||||||||||
| Phone: | FY'05 Allotment $100,000.00 | ||||||||||||||||||
| Fax: | CMS Requisition No. | 402-5-371004 | |||||||||||||||||
| Purchase Order No. | HHSM-500-2005-00144P | ||||||||||||||||||
| Estimated types of products | Funds Remaining | $34,559.00 | |||||||||||||||||
| Task # | Title | Pub. # | Revision Date | ICN # | Ink Page Count | Braille Page Count | Estimated Page Count | Estimated Total QTY Ordered | Estimated QTY to CMS Warehouse | Estimated QTY to Call Center | QTY to Partners | Due-Date | True Expenditure | Paid to Date | Funds Remaining | Invoice # | Estimated QTY to Partners | Estimated QTY of Addresses | Estimated Cost |
| 1 | Medicare & You 2014 | 10050B | September-05 | 004424 | 100 | 225 | 128 | 1550 | 200 | 700 | 650 | 52 | |||||||
| 2 | Choosing a Medigap Policy: 2014 Guide | 02110B | 56 | 550 | 375 | 175 | |||||||||||||
| 3 | Medicare Summary Notices | n/a | 5 | 6000 | 500 | ||||||||||||||
| 4 | CMS Publication TBD | TBD | 2 | 12 | 12 | ||||||||||||||
| 5 | CMS Publication TBD | TBD | 60 | 12 | 12 | ||||||||||||||
| Total Cost | |||||||||||||||||||
| Page 3 | |||||||||||||||||||
| Contractor: | |||||||||||||||||||
| Contract Administrator: | Budget Summary: | Period of Performance: 7/15/2014-7/14/2015 (Option Year 2) | |||||||||||||||||
| Phone: | FY'05 Allotment $100,000.00 | ||||||||||||||||||
| Fax: | CMS Requisition No. | 402-5-371004 | |||||||||||||||||
| Purchase Order No. | HHSM-500-2005-00144P | ||||||||||||||||||
| Estimated types of products | Funds Remaining | $34,559.00 | |||||||||||||||||
| Task # | Title | Pub. # | Revision Date | ICN # | Ink Page Count | Braille Page Count | Estimated Page Count | Estimated Total QTY Ordered | Estimated QTY to CMS Warehouse | Estimated QTY to Call Center | QTY to Partners | Due-Date | True Expenditure | Paid to Date | Funds Remaining | Invoice # | Estimated QTY to Partners | Estimated QTY of Addresses | Estimated Cost |
| 1 | Medicare & You 2015 | 10050B | September-05 | 004424 | 100 | 225 | 128 | 1550 | 200 | 700 | 650 | 52 | |||||||
| 2 | Choosing a Medigap Policy: 2015 Guide | 02110B | 56 | 550 | 375 | 175 | |||||||||||||
| 3 | Medicare Summary Notices | n/a | 5 | 6000 | 500 | ||||||||||||||
| 4 | CMS Publication TBD | TBD | 2 | 12 | 12 | ||||||||||||||
| 5 | CMS Publication TBD | TBD | 60 | 12 | 12 | ||||||||||||||
| Total Cost | |||||||||||||||||||
| Page 4 | |||||||||||||||||||
| Contractor: | |||||||||||||||||||
| Contract Administrator: | Budget Summary: | Period of Performance: 7/15/2015-7/14/2016 (Option Year 3) | |||||||||||||||||
| Phone: | FY'05 Allotment $100,000.00 | ||||||||||||||||||
| Fax: | CMS Requisition No. | 402-5-371004 | |||||||||||||||||
| Purchase Order No. | HHSM-500-2005-00144P | ||||||||||||||||||
| Estimated types of products | Funds Remaining | $34,559.00 | |||||||||||||||||
| Task # | Title | Pub. # | Revision Date | ICN # | Ink Page Count | Braille Page Count | Estimated Page Count | Estimated Total QTY Ordered | Estimated QTY to CMS Warehouse | Estimated QTY to Call Center | QTY to Partners | Due-Date | True Expenditure | Paid to Date | Funds Remaining | Invoice # | Estimated QTY to Partners | Estimated QTY of Addresses | Estimated Cost |
| 1 | Medicare & You 2016 | 10050B | September-05 | 004424 | 100 | 225 | 128 | 1550 | 200 | 700 | 650 | 52 | |||||||
| 2 | Choosing a Medigap Policy: 2016 Guide | 02110B | 56 | 550 | 375 | 175 | |||||||||||||
| 3 | Medicare Summary Notices | n/a | 5 | 6000 | 500 | ||||||||||||||
| 4 | CMS Publication TBD | TBD | 2 | 12 | 12 | ||||||||||||||
| 5 | CMS Publication TBD | TBD | 60 | 12 | 12 | ||||||||||||||
| Total Cost | |||||||||||||||||||
| Page 5 | |||||||||||||||||||
| Contractor: | |||||||||||||||||||
| Contract Administrator: | Budget Summary: | Period of Performance: 7/15/2016-7/14/2017 (Option Year 4) | |||||||||||||||||
| Phone: | FY'05 Allotment $100,000.00 | ||||||||||||||||||
| Fax: | CMS Requisition No. | 402-5-371004 | |||||||||||||||||
| Purchase Order No. | HHSM-500-2005-00144P | ||||||||||||||||||
| Estimated types of products | Funds Remaining | $34,559.00 | |||||||||||||||||
| Task # | Title | Pub. # | Revision Date | ICN # | Ink Page Count | Braille Page Count | Estimated Page Count | Estimated Total QTY Ordered | Estimated QTY to CMS Warehouse | Estimated QTY to Call Center | QTY to Partners | Due-Date | True Expenditure | Paid to Date | Funds Remaining | Invoice # | Estimated QTY to Partners | Estimated QTY of Addresses | Estimated Cost |
| 1 | Medicare & You 2017 | 10050B | September-05 | 004424 | 100 | 225 | 128 | 1550 | 200 | 700 | 650 | 52 | |||||||
| 2 | Choosing a Medigap Policy: 2017 Guide | 02110B | 56 | 550 | 375 | 175 | |||||||||||||
| 3 | Medicare Summary Notices | n/a | 5 | 6000 | 500 | ||||||||||||||
| 4 | CMS Publication TBD | TBD | 2 | 12 | 12 | ||||||||||||||
| 5 | CMS Publication TBD | TBD | 60 | 12 | 12 | ||||||||||||||
| Total Cost |
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Sheet3
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| 11154 WEB Nov 20111.pdf | ||
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| MSN B sample1.pdf | ||
| SOW for Braille Contract for 2012 w revisions for MSNs and On-Demand.docx | DOCX document | |
| Weights Measures for Evaluating Braille Contractors.xls | XLS spreadsheet |
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