Atch E - Timesheet for Contract Service.xlsx
XLSX spreadsheet 11 KB Posted
- Solicitation number
- RFP-22-PHX-13
About this file
This solicitation is seeking proposals for hospitalist services at the Parker Indian Health Service Hospital in Parker, Arizona. The requirement is for non-personal professional hospitalist services to be provided under a firm fixed-price contract with an estimated base period of November 1, 2022 through October 30, 2023 and four one-year option periods. The North American Industry Classification System code is 621111 for offices of physicians and the size standard is $14 million. The solicitation sets aside the requirement for Native American firms in accordance with the Buy Indian Act of 1910 and is identified as solicitation number RFP-22-PHX-13. Proposals are due electronically by the date specified in Attachment G and must include the rate schedule, business associate agreement, technical proposal, and past performance information. The Department of Health and Human Services Indian Health Service will award to the responsible and responsive offeror providing the best value based on price and non-price factors.
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Text version
Sheet1
| COLORADO RIVER SERVICE UNIT |
| 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 .