A19-J.1 - Pricing Schedule.xlsx
XLSX spreadsheet 51 KB Posted
- Solicitation number
- 1605C3-25-R-00004
About this file
This file is an Independent Government Cost Estimate (IGCE) for Medical Second Opinion and Examination Services for the Department of Labor's Office of Workers' Compensation Programs (OWCP). The procurement seeks board-certified, licensed physicians to perform impartial medical second opinion evaluations and referee medical examinations for Federal Employees' Compensation Act (FECA) program claimants nationwide. The IGCE covers a base period and four option periods, with an estimated total contract value of $3,000,000, including escalation factors of 6% based on GDP and Employee Cost Index projections.
The cost estimate includes detailed breakdowns for various medical services such as medical second opinions, schedule award/impairment ratings, supplemental reports, follow-up reports, file reviews, and independent medical examinations. Additional cost considerations include travel/transportation estimated at $379,940, reimbursement for canceled appointments at $60 per occurrence, and diagnostic testing estimated at 80% of all services. The government developed this estimate using historical referral data, market intelligence sessions, and input from OWCP economists, with the solicitation (1605C3-25-R-00004) issued under FAR Part 12 and Part 15 procedures for commercial services acquisition.
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Other files
| File | Type | Posted |
|---|---|---|
| A19-J.3 - QUESTION AND ANSWER SPREADSHEET.xlsx | XLSX spreadsheet | |
| A19-J.4 – PAST PERFORMANCE QUESTIONNAIRE.docx | DOCX document | |
| A19-J.2 – SMALL BUSINESS SUBCONTRACTING PLAN TEMPLATE.xlsx | XLSX spreadsheet | |
| 1605C3-25-R-00004.pdf | ||
| A19-J.2 – SMALL BUSINESS SUBCONTRACTING PLAN TEMPLATE.docx | DOCX document |
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Instructions
| INSTRUCTIONS FOR INDEPENDENT GOVERNMENT COST ESTIMATE (IGCE) TEMPLATE | |
| This IGCE is an Excel document composed of 3 individual sheets: |
| --Instructions (the current one) | ||
| --IGCE Sample | ||
| --IGCE Template | ||
| See the tabs at the bottom of the screen. When you click on a tab, the worksheet is displayed, and the tab is highlighted. | ||
| What Data to Enter | ||
| --Originating Office: This is the name and address of the DOL agency/business unit preparing the IGCE. | ||
| --Date Submitted: This is the date that the IGCE is prepared/submitted to OSPE. | ||
| --Project No.: This is the requisition number, if known. | ||
| --Contract No.: This is the current contract or order number, if this IGCE action is for a modification to an existing contract or order. | ||
| --Purpose (project name): This is a brief description of the requirement. | ||
| --Estimated by (print name): This is generally the name of the Contracting Officer's Represenative (COR), or the name of the individual who prepared the estimate. | ||
| --Base and Option Periods: This is the base period of performance, and optional periods of performance, if any. | ||
| --Description of Work: This is the product/good/equipment to be provided by the contractor, which forms the basis of the estimate. | ||
| --Quantity - This is the number of units to be provided by the contractor. | ||
| --Unit of Measure - This is the description of how the items are measured. | ||
| --Unit Price - This is the estimated unit price. | ||
| --Subtotals - This is the quantity multiplied by the unit price. This field calculates automatically. | ||
| --Labor Categories - This is the name of any labor categories expected under the contract. | ||
| --Per Hour - This is the estimated hourly rate for each labor category. | ||
| --Sub-Total (Base Period, option periods, etc) - This is the total amount of all materials and labor. These amounts calculate automatically. | ||
| --Base Period (option periods, etc.) - This is the total amount of all materials and labor combined. These amounts calculate automatically. | ||
| --Escalation - This is the annual price escalation. Enter the percentage for each option period. The spreadsheet will automatically apply the escalation to the option period pricing. | ||
| --Sources for Independent Government Cost Estimate - These are the sources used to develop the IGCE. Place a box in the choice that reflects the source of information used to prepare the estimate. | ||
| --Discuss The Rationale For The Independent Government Cost Estimate (IGCE) - This is a narrative explanation of how the IGCE was derived. | ||
| --Signature of Preparer - This is the name and title of the individual who prepared the IGCE. | ||
| --Phone - This is the phone number of the preparer. | ||
| --Email - This is the email address of the preparer. | ||
| Tips for using the IGCE Template | ||
| -- When you exit the spreadsheet, you will be prompted to save it. Remember that, | ||
| when you use it the next time, it will open onto the worksheet and cell you were on | ||
| when you last saved it. | ||
| -- You may print each spreadsheet. | ||
| -- You may separate the IGCE Template and create a new file for your IGCE by doing the following: | ||
| -- Right click on the IGCE Template tab | ||
| -- Select "Move or Copy" | ||
| -- In the drop-down select "(new book)" | ||
| -- Check the box for "create a copy" | ||
| -- Select "OK" | ||
| -- A new file will be created. Be sure to save the new file containing the IGCE. | ||
| THIS IS THE END OF THE INSTRUCTIONS. |
IGCE SAMPLE
OSPE Independent Government Cost Estimate
Note: The columns highlighted in gray will automatically calculate. You do not need to fill in anything in those columns.
| ORIGINATING OFFICE | DATE SUBMITTED | PROJECT NO. | CONTRACT NO. (For Mods) | |
| Bureau of Labor Statistics | 2/1/22 | |||
| ESTIMATE | PURPOSE (Project Name) | |||
| WORKSHEET | 200 Constitution Ave NW | Office of Compensation and Working Conditions Tableau Software Analysis and Support | ||
| Washington DC 20201 |
| ESTIMATED BY (Print Name) | ||||||||||
| John Doe, COR | ||||||||||
| Base Period: June 1, 2022-May 31, 2023 | QUANTITY | MATERIAL/SUPPLIES | LABOR | |||||||
| Period | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||
| UNITS | MEASURE | UNIT | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | HOUR | SUBTOTALS | ||
| Base | ||||||||||
| Statistical Publication A | 1 | EACH | $1,000.00 | $1,000.00 | Economist | 1,000 | hours | $75.00 | $75,000.00 | |
| Statistical Publication B | 1 | EACH | $2,000.00 | $2,000.00 | Statistician | 501 | hours | $75.00 | $37,575.00 | |
| $0.00 | Program Manager | 40 | hours | $75.00 | $3,000.00 | |||||
| $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 |
Sub-Total Base Period $3,000.00 $115,575.00
Base Period $118,575.00
| Option Period One: June 1, 2023-May 31, 2024 | QUANTITY | MATERIAL/SUPPLIES | LABOR | |||||||||
| 1st | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | HOUR | Escalation | SUBTOTALS | ||
| Statistical Publication A | 1 | EACH | $1,030.00 | 3.00% | $1,030.00 | Economist | 1,000 | hours | $77.25 | 3.00% | $77,250.00 | |
| Statistical Publication B | 1 | EACH | $2,060.00 | 3.00% | $2,060.00 | Statistician | 501 | hours | $77.25 | 3.00% | $38,702.25 | |
| $0.00 | $0.00 | Program Manager | 40 | hours | $77.25 | 3.00% | $3,090.00 | |||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period One $3,090.00 $119,042.25
Option Period One $122,132.25
| Option Period Two: June 1, 2024-May 31, 2025 | QUANTITY | MATERIAL/SUPPLIES | LABOR | |||||||||
| 2nd | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | SUBTOTALS | ||
| Statistical Publication A | 1 | EACH | $1,060.90 | 3.00% | $1,060.93 | Economist | 1,000 | hours | $79.57 | 3.00% | $79,567.50 | |
| Statistical Publication B | 1 | EACH | $2,121.80 | 3.00% | $2,121.80 | Statistician | 501 | hours | $79.57 | 3.00% | $39,863.32 | |
| $0.00 | $0.00 | Program Manager | 40 | hours | $79.57 | 3.00% | $3,182.70 | |||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Two $3,182.73 $122,613.52
| Option Period Two | $125,796.25 | |||||||||||
| 3rd | Option Period Three: June 1, 2025-May 31, 2026 | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||
| DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | ||||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | SUBTOTALS | ||
| Statistical Publication A | 1 | EACH | $1,092.73 | 3.00% | $1,092.76 | Economist | 1,000 | hours | $81.95 | 3.00% | $81,954.53 | |
| Statistical Publication B | 1 | EACH | $2,185.45 | 3.00% | $2,185.45 | Statistician | 501 | hours | $81.95 | 3.00% | $41,059.22 | |
| $0.00 | $0.00 | Program Manager | 40 | hours | $81.95 | 3.00% | $3,278.18 | |||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Three $3,278.21 $126,291.92
| Option Period Three | $129,570.13 | |||||||||||
| 4th | Option Period Four: June 1, 2026-May 31, 2027 | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||
| DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | ||||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | SUBTOTALS | ||
| Statistical Publication A | 1 | EACH | $1,125.51 | 3.00% | $1,125.54 | Economist | 1,000 | hours | $84.41 | 3.00% | $84,413.16 | |
| Statistical Publication B | 1 | EACH | $2,251.02 | 3.00% | $2,251.02 | Statistician | 501 | hours | $84.41 | 3.00% | $42,290.99 | |
| $0.00 | $0.00 | Program Manager | 40 | hours | $84.41 | 3.00% | $3,376.53 | |||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 | |||||||||
| $0.00 | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Four $3,376.56 $130,080.68
| Option Period Four | $133,457.24 | ||
| Contract Value with Options | $629,530.87 | ||
| SOURCE(S) FOR INDEPENDENT GOVERNMENT COST ESTIMATE (IGCE): | |||
| GSA Schedule: X | Catalogs: | Previous Buys: | |
| Published Price List: | Market Surveys: | Other: |
| DISCUSS THE RATIONALE FOR THE INDEPENDENT GOVERNMENT COST ESTIMATE (IGCE) |
| Narrative: |
| I prepared this IGCE by reviewing the pricing of three vendors on GSA IT Schedule 70. |
| I completed my review on January 4, 2022. |
| I calculated the average of the vendors' hourly rates and unit prices to develop the base year pricing. |
| A 3% escalation was applied to each of the option periods, based on the BLS Consumer Price Index released on January 10, 2022. |
Signature of Preparer:________________________John Doe, COR______________________________________
Phone: 202-693-1234
Email: Doe.John@dol.gov
2025 SECOP - IGCE
| Base Period: | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||
| Period | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | ||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | HOUR | SUBTOTALS | ||
| Base | Medical Second Opinion and Examination Services | 18,000 | Case | 0.00% | $0.00 | $0.00 | $0.00 | ||||
| Schedule Award/Impairment Ratings | 3000 | Case | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| Supplemental Reports | 1800 | Each | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| Follow-up Reports | 500 | Each | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| File Review Only | 200 | Case | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| IME | 600 | Case | 0.00% | $0.00 | |||||||
| Travel/Transportation | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| Other Direct Cost - Canceled Appointments, Interpretive Services, Diagnostic Tests | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 |
Sub-Total Base Period $0.00 $0.00 $0.00
Base Period $0.00
| Option Period One: | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||||
| 1st | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | ||||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | HOUR | Escalation | SUBTOTALS | |||
| Medical Second Opinion and Examination Services | 18,000 | Case | 6.00% | $0.00 | $0.00 | ||||||||
| Schedule Award/Impairment Ratings | 3000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | The subtotals aren't carrying over. | ||||||
| Supplemental Reports | 1800 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||||
| Follow-up Reports | 500 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||||
| File Review Only | 200 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||||
| IME | 600 | Case | 6.00% | $0.00 | |||||||||
| Travel/Transportation | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 | |||||||
| Other Direct Cost - Canceled Appointments, Interpretive Services, Diagnostic Tests | 1 | Fee | 0.00% | $3,000,000.00 | $0.00 | $0.00 |
Sub-Total Option Period One $3,000,000.00 $0.00 $0.00
Option Period One $3,000,000.00
| Option Period Two: | QUANTITY | MATERIAL/SUPPLIES | LABOR | |||||||||
| 2nd | DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | SUBTOTALS | ||
| Medical Second Opinion and Examination Services | 18,000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | ||||||
| Schedule Award/Impairment Ratings | 3000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | ||||||
| Supplemental Reports | 1800 | Each | 6.00% | $0.00 | $0.00 | $0.00 | ||||||
| Follow-up Reports | 500 | Each | 6.00% | $0.00 | $0.00 | $0.00 | ||||||
| File Review Only | 200 | Case | 6.00% | $0.00 | $0.00 | $0.00 | ||||||
| IME | 600 | Case | 6.00% | $0.00 | ||||||||
| Travel/Transportation | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 | ||||||
| Other Direct Cost - Canceled Appointments, Interpretive Services, Diagnostic Tests | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Two $0.00 $0.00 $0.00
| Option Period Two | $0.00 | ||||||||||
| Option Period Three: | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||
| DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | ||
| Medical Second Opinion and Examination Services | 18,000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Schedule Award/Impairment Ratings | 3000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Supplemental Reports | 1800 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Follow-up Reports | 500 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| File Review Only | 200 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| IME | 600 | Case | 6.00% | $0.00 | |||||||
| Travel/Transportation | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 | |||||
| Other Direct Cost - Canceled Appointments, Interpretive Services, Diagnostic Tests | 1 | Fee | 0.00% | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Three $0.00 $0.00 $0.00
| Option Period Three | $0.00 | ||||||||||
| Option Period Four: | QUANTITY | MATERIAL/SUPPLIES | LABOR | ||||||||
| DESCRIPTION OF WORK | NO. | UNIT | PER | LABOR | UNIT | PER | |||||
| UNITS | MEASURE | UNIT | Escalation | SUBTOTALS | CATEGORY | QUANTITY | MEASURE | UNIT | Escalation | ||
| Medical Secnd Opinion and Examination Services | 18,000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Schedule Award/Impairment Ratings | 3000 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Supplemental Reports | 1800 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| Follow-up Reports | 500 | Each | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| File Review Only | 200 | Case | 6.00% | $0.00 | $0.00 | $0.00 | |||||
| IME | 600 | Case | 6.00% | $0.00 | |||||||
| Travel/Transportation | 1 | fee | 0.00% | $0.00 | $0.00 | ||||||
| Other Direct Cost - Travel, Canceled Appointments, Transportation, Interpretive Services, Diagnostic Tests | 1 | fee | 0.00% | $0.00 | $0.00 | $0.00 |
Sub-Total Option Period Four $0.00 $0.00 $0.00
| Option Period Four | $0.00 | ||
| Contract Value with Options | $3,000,000.00 | ||
| SOURCE(S) FOR INDEPENDENT GOVERNMENT COST ESTIMATE (IGCE): | |||
| GSA Schedule: | Catalogs: | Previous Buys: X | |
| Published Price List: | Market Surveys: | Other: Market Intelligence Sessions |
| DISCUSS THE RATIONALE FOR THE INDEPENDENT GOVERNMENT COST ESTIMATE (IGCE) |
| Narrative: |
| Due to the nature of SECOP services, OWCP can not guarantee more than 1 unit per service for SECOP, Supplemental Reports, Follow-Up Reports, File Review, IME, and Schedule Awards/Impairment Ratings. The above estimates are based on the a historical data regarding a recent 1 year volume and the % of historical distribution of referals by specality and geographic locaionts. these figurea are only for the purposes for evaluation and not garenteed operational volumes. plus an escalation factor of 6%. The 6% is based on input from the OWCP economist, who researched OMB projections for price impacts over the next several years and applied relevant 3.2% Gross Domestic Product (GDP) increase plus a 2.9% Employee Cost Index increase (with rounding). In addition, OWCP has determined that payment for Cancellation of Appointments shall be reimbursed at a pre-determined rate of $60.00 per occurrence which is consistent with the current average rate in the Open Market. Diagnostic Testing and Procedures are estimated at 80% of all services. Travel and Transportation is estimated at $379,940.00. |
Signature of Preparer:______________________________________________________________
Phone: 904-366-0593
Email: crespo.hilda.r@dol.gov
File details come from the government source that posted it. Updated .