Appendix 1- Price Breakdown and Calculation of Self-Performed Work- 589-22-885-Issued 02.docx
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- Solicitation number
- 36C25524R0097
About this file
This document is an Appendix 1 - Price Breakdown and Calculation of Self-Performed Work for Solicitation 36C25524R0097, which is for the project "Expand Sterile Processing Service Space to Meet Requirements" for the Department of Veterans Affairs.
The document requires the contractor to provide a detailed breakdown of material and personnel costs by specification division for the project. It also requires the contractor to calculate the percentage of self-performed work, and to list all Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) that will be working on the contract. The contractor must certify that the information provided is true and correct.
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Text version
APPENDIX 1- PRICE BREAKDOWN AND CALCULATION OF SELF-PERFORMED/SUBCONTRACTED WORK
Solicitation: 36C25524R0097 Project: 589-22-885 Expand Sterile Processing Service Space to Meet Requirements Provide a breakdown of material and personnel costs, by specification division listed for the project. Home Office overhead, profit/fee and bond costs shall be added after a subtotal of personnel and material/equipment costs has been calculated. Clearly identify the personnel costs you will be performing, and the personnel costs of other eligible service disabled veteran-owned small business concerns. Below is the required format.
THIS DOCUMENT MUST BE COMPLETED FOR EACH BID ITEM.
| Specification Division |
| SDVOB Vendor (Y or N) |
| Personnel Cost |
| Material/Equipment Costs |
| TOTAL COSTS |
Division 01
| $ |
| $ |
| $ |
Division 02
| $ |
| $ |
| $ |
Division 03
| $ |
| $ |
| $ |
Division 04
| $ |
| $ |
| $ |
Division 05
| $ |
| $ |
| $ |
Division 06
| $ |
| $ |
| $ |
Division 07
| $ |
| $ |
| $ |
Division 08
| $ |
| $ |
| $ |
Division 09
| $ |
| $ |
| $ |
Division 10
| $ |
| $ |
| $ |
Division 11
| $ |
| $ |
| $ |
Division 12
| $ |
| $ |
| $ |
Division 13
| $ |
| $ |
| $ |
Division 14
| $ |
| $ |
| $ |
Division 21
| $ |
| $ |
| $ |
Division 22
| $ |
| $ |
| $ |
Division 23
| $ |
| $ |
| $ |
Division 26
| $ |
| $ |
| $ |
Division 27
| $ |
| $ |
| $ |
Division 28
| $ |
| $ |
| $ |
Guarantee Period of Service (if required)
| $ |
| $ |
| $ |
| Sub Total (Personnel Costs, Material/Equipment Costs) |
| $ |
| $ |
| $ |
| Profit |
| $ |
| $ |
| Home Office Overhead |
| $ |
| $ |
| Bond |
| $ |
| $ |
| Grand Total |
| $ |
| $ |
Calculation of self-performed personnel costs:
1. Total personnel costs * both prime and all subcontractors: $_________________
2. Subtract all subcontractor personnel costs* that are not SDVOSB companies that will perform work on this contract: $__________________
3. Remainder is Total amount of work to be self-performed under the Contract: $__________________
4. Self-performed work = Line 3/Line 1 x 100 = _____%
LIST THE NAMES OF ALL SDVOSB CONTRACTORS THAT WILL BE WORKING THE ABOVE DIVISIONS. SDVOSB MUST BE SMALL FOR NAICS 236220 TO BE USED TO MEET THE 85% REQUIREMENT AS STATED IN ACCORDANCE WITH VAAR 852.219-75(a)(1)(ii).
I certify the above representations are true and correct to the best of my knowledge.
| Signed: _________________________________ | ___________ | |
| Date |
(Typed Name of Authorized Representative)
(Title of Authorized Representative)
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