Atch E - Timesheet for Contract Service HHCC.xlsx
XLSX spreadsheet 11 KB Posted
- Solicitation number
- RFP-22-PHX-08
About this file
This combined synopsis and solicitation requests proposals for family practice physician services at the Hopi Health Care Center in Polacca, Arizona. The Indian Health Service intends to award a firm fixed-price contract for an estimated base period of July 15, 2022 through July 14, 2023, with four optional one-year extension periods. The North American Industry Classification System code for this acquisition is 621111 for offices of physicians, with a size standard of $12 million. Proposals must be submitted electronically to Michele.Lodge@ihs.gov by the response date, with the rate schedule, technical proposal, and past performance data attached as instructed. The solicitation is set aside for Native American firms according to the Buy Indian Act of 1910, with no opportunities for joint ventures, teaming arrangements, or subcontracting.
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Text version
Sheet1
| Hopi Health Care Center (HHCC) |
| 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 .