Atch E - Timesheet for Contract Service.xlsx
XLSX spreadsheet 11 KB Posted
- Attached to
- Emergency Department NP and PA Services at PIMC
- Solicitation number
- RFP-22-PHX-01
About this file
This document contains a solicitation for emergency department nurse practitioner and physician assistant services. The solicitation is set aside for Native American firms in accordance with the Buy Indian Act and seeks to award a firm fixed price contract for non-personal professional services at the Phoenix Indian Medical Center emergency department. The period of performance is from August 1, 2022 to July 31, 2023 with four option years. Proposals are due by email to Michele.Lodge@ihs.gov and must include the rate schedule, technical proposal, and past performance data using the attachments provided. The North American Industry Classification System code is 621399 and size standard is $7.5 million.
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Text version
Sheet1
| PHOENIX INDIAN MEDICAL CENTER |
| STANDARD TIMESHEET FOR CONTRACT SERVICES |
| Contract Number:_____________________________ |
| PRINTED CONTRACTOR'S NAME:____________________________________DEPT/SERVICE__________________________________________ |
"I hereby certify that the hours worked during the weeks noted below are correct and are in accordance to the terms of the contract"
SIGNATURE OF CONTRACTOR: _________________________________________________ DATE SIGNED: ____________________________
| WEEK OF _________________________________________ | ||||||
| Weekday | Date | Time In | Lunch | Time Out | Total Hours | Description of Hours |
| Week of _________________________________ | ||||||
| Weekday | Date | Time In | Lunch | Time Out | Total Hours | Description of Hours |
"I hereby certify that the contract services provided in this timesheet are correct and are in accordance to the terms of the contract"
VERIFIED BY Department Receiving Official (Printed Name/Signature):_______________________________________________________________________
Contracting Officer Representative (Printed Name/Signature):________________________________________________________________________________
Sheet2
Sheet3
File details come from the government source that posted it. Updated .