Atch E - Timesheet for Contract Service.xlsx
XLSX spreadsheet 12 KB Posted
- Solicitation number
- RFP-25-PHX-07
About this file
This is a timesheet template for contract services at the Phoenix Indian Medical Center. The timesheet includes fields for contractor name, contract number, department/service, and two weekly time tracking sections with columns for date, time in/out, lunch, total hours, and description of hours. The form requires certification from both the contractor and verification signatures from the Department Receiving Official and Contracting Officer Representative to confirm the hours worked comply with contract terms.
The related solicitation (RFP-25-PHX-07) is for Maternal Fetal Medicine Physician Services at Phoenix Indian Medical Center, set aside for Native American firms under the Buy Indian Act of 1910. This is a firm-fixed-price contract with a base period from March 24, 2025 through March 23, 2026, plus four option years. The NAICS code is 621111 with a $16M size standard. Proposals must be submitted electronically to specified IHS contracting officials, and contractors must be registered in SAM prior to award.
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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 .