Atch E - Time Sheet.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- BIA Set-Aside: Pathology Physicians at PIMC
- Solicitation number
- 75H71225C00001
About this file
The provided document is a timesheet template for contract services under Contract Number 75H71225C00001 for Pathology Physician Services at the Phoenix Indian Medical Center. The timesheet includes fields for the contractor company name, provider's name, service provided, and a detailed breakdown of hours worked by day, including descriptions of the hours (e.g., call-back, on-call, overtime, regular time). The timesheet requires verification by a department manager and approval by a certified Contracting Officer's Representative (COR).
The related federal contract opportunity is a notice of award for RFQ-25-PHX-002, Pathology Physician Services at the Phoenix Indian Medical Center. The contract, 75H71225C00001, was awarded to Prairie Band Health Services Inc. for $6,748,560 on November 21, 2024. The contract was set aside for the Bureau of Indian Affairs (BIA), and the awarding agency was the Department of Health and Human Services Indian Health Service (IHS).
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Text version
Sheet1
| PHOENIX INDIAN MEDICAL CENTER |
| STANDARD TIMESHEET FOR CONTRACT SERVICES |
CONTRACT NUMBER: 75H712 CONTRACTOR (Company Name)
PRINTED PROVIDER'S NAME:____________________________________ SERVICE PROVIDED: PATHOLOGY PHYSICIAN SERVICES
SIGNATURE OF PROVIDER: ___________________________________________________ DATE SIGNED: _____________________________
(Description of Hours: Call-Back, On-Call, Overtime, Regular Time, etc. - # Hours, Description of Hours, Hours Need to Match Invoice/Contract)
| WEEK OF _________________________________________ | |||||||
| Weekday | Date | Time IN | Lunch Out | Lunch In | Time OUT | Total Hours | Description of Hours |
| WEEK OF ________________________________________ | |||||||
| Weekday | Date | Time IN | Lunch Out | Lunch In | Time Out | Total Hours | Description of Hours |
VERIFIED BY Dept. Manager (Printed Name):_____________________________________ Signature: ___________________________________________________
APPROVED BY Certified COR (Printed Name):_____________________________________ Signature: __________________________________________________
File details come from the government source that posted it. Updated .