ASMC-Financial-TOP-WCCB7600007.xlsx

XLSX spreadsheet 28 KB Posted

Attached to
FY27 Self Insured Audit (1)
Solicitation number
BPM058662
Issued by
Maryland

About this file

This is a Financial TOP (Technical and Operational Proposal) form for Maryland's FY27 Self Insured Audit contract opportunity (TORFP: WCCB7600007), with ASC Financial identified as the Master Contractor. The audit aims to determine the validity and accuracy of claim payments, case reserve estimates, and reporting submitted by selected self-insured employers on selected portions of the IC-1 Annual Information Report. The contract structure includes a base period of 8 months from Notice to Proceed (NTP) beginning X/X/2026 through X/X/2027, followed by four additional option years. The form requires bidders to propose labor resources across nine defined labor categories: Partner, Manager, Cost Accountant, Financial Analyst, Audit Supervisor, Senior Auditor, Staff Auditor, Subject Matter Expert, and Business Process Consultant, with associated not-to-exceed rates and hours for each contract year.

The Financial TOP form mandates that proposed rates for each labor category must not exceed the firm's approved Not-To-Exceed Labor Category Rates under the Master Contract. Bidders must ensure that total hours proposed in the Technical Proposal align precisely with hours submitted in the Financial Proposal for each labor category and contract year, with all calculations for labor costs (rate multiplied by hours) recorded in designated columns. The form includes provision for non-routine travel cost reimbursement as a line item if applicable. The total evaluated price, calculated by summing all labor dollars across contract years and any approved travel costs, represents the firm's complete financial offer for the work and will be used in the evaluation process. All submissions must include completed TORFP number, firm name, affiant information, and Master Contractor firm details, and no alterations or assumptions to the form are permitted.

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TORFP-WCCB7600007 -10-07-2026(TW9.28.26).docx DOCX document

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Sheet1

TORFP:WCCB7600007
Master Contractor:ASC FINANCIAL TOP
ABCDEFGHIJKLMNOPQRS
8 Months from NTPBase YR-2Base YR-3Base YR-4Base YR-5TOTAL HRTOTAL $
X/X/2026 thru X/X/2027X/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXBase YR-1 thru
LINELaborRATEYR-1YR-1RATEYR-2YR-2RATEYR-3YR-3RATEYR-4YR-4RATEYR-5YR-5Base YR-5
ITEMCategory$TOT HRSTOT $$TOT HRS$$TOT HRS$$TOT HRS$$TOT HRS$(Set for Auto Calculation)
1Partner$0.00$0.00$0.00$0.00$0.000$0.00
2Manager$0.00$0.00$0.00$0.00$0.000$0.00
3Cost Accountant$0.00$0.00$0.00$0.00$0.000$0.00
4Financial Analyst$0.00$0.00$0.00$0.00$0.000$0.00
5Audit Supervisor$0.00$0.00$0.00$0.00$0.000$0.00
6Senior Auditor$0.00$0.00$0.00$0.00$0.000$0.00
7Staff Auditor$0.00$0.00$0.00$0.00$0.000$0.00
8Subject Matter Expert$0.00$0.00$0.00$0.00$0.000$0.00
9Business Process Consultant$0.00$0.00$0.00$0.00$0.000$0.00
Option YR-1Option YR-2Option YR-3Option YR-4Option YR-5TOTAL HRTOTAL $
X/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXX/X/20XX thru X/X/20XXOption YR-1 thru
LINELaborRATEYR-1YR-1RATEYR-2YR-2RATEYR-3YR-3RATEYR-4YR-4RATEYR-5YR-5Option YR-5
ITEMCategory$TOT HRSTOT $$TOT HRS$$TOT HRS$$TOT HRS$$TOT HRS$(Set for Auto Calculation)
1Partner$0.00$0.00$0.00$0.00$0.000$0.00
2Manager$0.00$0.00$0.00$0.00$0.000$0.00
3Cost Accountant$0.00$0.00$0.00$0.00$0.000$0.00
4Financial Analyst$0.00$0.00$0.00$0.00$0.000$0.00
5Audit Supervisor$0.00$0.00$0.00$0.00$0.000$0.00
6Senior Auditor$0.00$0.00$0.00$0.00$0.000$0.00
7Staff Auditor$0.00$0.00$0.00$0.00$0.000$0.00
8Subject Matter Expert$0.00$0.00$0.00$0.00$0.000$0.00
9Business Process Consultant$0.00$0.00$0.00$0.00$0.000$0.00
10NTE NON-ROUTINE TRAVEL $:
11TOTAL EVALUATED PRICE:$0.00
FINANCIAL TOP INSTRUCTIONS:==========
DO NOT ALTER THE FORM, OR GIVE ASSUMPTIONS. ANY SUCH INFORMATION WILL BE CONSIDERED A CONDITIONED OFFER.
1)The total hours in your Technical Proposal must be the same per Labor Category and Contract Year(s) (CY) as what you provide here in your Financial Proposal. Enter zeros for each rate or hour slot not used.
2)For each Contract Year applicable to your Technical Work Plan, complete each Labor Cateogy line with a NTE rate and hours. Then multiply the NTE rate by the hours and record that answer in the applicable Contract Year $, for that line item (Columns E, H, K, N, Q).SignatureDate
3)For Columns R and S: For each Labor Category line item, add all the Contract Year Hours together and record the answer in Column R for that line item. Then add each Contract Year's total dollars together and record that answer in Column S.Title
4)Rates utilized for each Labor Category and Contract Year must be at or below your Firm's approved Not To Exceed Labor Category Rates under the Master Contract.Typed Name of Affiant
5)If stipulated in the TORFP, Line 10 is for any Not-To-Exceed Non-Routine Travel cost reimbursement (example: dollars associated with mileage) only. Any associated labor dollars are reflected in your Work Plan and in the labor hours. If zero dollars are proposed, record a zero.Contact Information (Telephone and Email)
6)Grand Total only the dollars in Column S (Total $). Record this number in Line Item 10 in the K column. This is your Total Evaluated Price that becomes your Financial TOP Offer for the applicable TORFP work.
7)The TOTAL EVALUATED PRICE is the dollar amount that will be evaluated, and represents your Firm's offer for the work proposed under the applicable TORFP.Typed Name of Master Contractor's FirmFEIN Number
8)Complete the TORFP number and your Firm's name at the top left of the sheet. Complete the affiant information to the right. Submit this completed sheet as your Firm's Financial TOP.

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