Atch E - Timesheet for Contract Service.xlsx
XLSX spreadsheet 11 KB Posted
- Attached to
- Emergency Room Physicians at PIMC Federal contract opportunity
- Solicitation number
- RFP-22-PHX-09
About this file
This document contains a federal contract opportunity solicitation and related timesheet template. The solicitation seeks proposals to provide emergency room physician services on a firm fixed price basis at the Phoenix Indian Medical Center in Phoenix, Arizona. The period of performance is estimated from July 15, 2022 to July 14, 2023 with four optional one-year extensions. Proposals are due by July 12, 2022. The NAICS code is 621111 for offices of physicians and the size standard is $12 million. The attached timesheet template must be used by contractors to record hours worked and certify performance is in accordance with contract terms.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| RFP-22-PHX-09 Questions and Answers.pdf | ||
| Questions ER PHY HHCC.pdf | ||
| Continuation SF 1449 REV 23 June 2022.pdf | ||
| 75H71222R00045 ER PHY PIMC Approved REV 23 Jun 22.pdf | ||
| Continuation SF 1449 rev 23 Jun 22.pdf | ||
| 75H71222R00044 Approved REV.pdf | ||
| Atch B - Business Associate Agreement.pdf | ||
| Atch C - 2022 Tax Exemption.pdf | ||
| Atch G - IHS IEE Representation Form.pdf | ||
| Atch F- Wage Determination 2015-5469 dtd 15 Mar 2022.pdf | ||
| Atch D- Statement of Work ER Physician REV2.pdf | ||
| Continuation SF 1449.pdf | ||
| Atch A - Rate Schedule ER Physician Services.xlsx | XLSX spreadsheet | |
| 75H71222R00045 ER PHY PIMC Approved.pdf |
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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 .