Att_D_MedUtilities.pdf

PDF 42 KB Posted Jan 21, 2021

Attached to: Regional Rental Surveys Federal contract opportunity
Solicitation number: 140D0421R0017
Issued by: Department of the Interior Departmental Offices Interior Business Center

View the file

Other files for this federal contract opportunity

Other files attached to Regional Rental Surveys, newest first.
File	Type	Posted
Att_A_Communities.pdf	PDF	Jan 21, 2021
Att_C_OS2001.pdf	PDF	Jan 21, 2021
Att_E_HousingData.pdf	PDF	Jan 21, 2021
Att_B_OS2000.pdf	PDF	Jan 21, 2021
Source Sought Notice 140D0421R0017.pdf	PDF	Jan 21, 2021
Attachment 1 - Rental Survey SOW.docx	DOCX document	Jan 21, 2021
Attachment 2 - Vendor Question Template.docx	DOCX document	Jan 21, 2021

On GovTribe

Work with this file on GovTribe

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

ATTACHMENT D COMMUNITY MEDICAL/UTILITIES SURVEY

Community Medical and Utilities Survey

Survey Region________ Survey Year____________

Survey Community/State______________________________

Collected By_____________________________ Date Collected_______________________

Doctor Office/Clinic/Business Name___________________________________________________________

Not Available (Contact IBC immediately because community is not valid)

Accepting New Patients (If not, survey another doctor in the community)

Doctor Name(s)______________________________________________________________________

Address____________________________________________________________________________

Phone/Web__________________________________________________________________________

Comments/Hours_____________________________________________________________________

Dentist Office/Clinic/Business Name__________________________________________________________

Not Available (Contact IBC immediately because community is not valid)

Accepting New Patients (If not, survey another dentist in the community)

Dentist Name(s)______________________________________________________________________

Address____________________________________________________________________________

Phone/Web__________________________________________________________________________

Comments/Hours____________________________________________________________________

Electric Utility Company Name_______________________________________________________________

Copy of rate sheets required

Phone/Web__________________________________________________________________________

Comments/Contact Name_______________________________________________________________

Method 1: Cost to Residential Customers: (average summer/winter rates if applicable; include all taxes) 500 KwH____________ 1,000 KwH___________ 1,500 KwH___________ 2,000 KwH___________

Method 2: Contractor can enter into iQMIS the following cost components:

Summer/Year-Round (_____Months) Winter (______Months)

Tier 1 ______ KwH @ Tier 1 Rate ___________ Tier 1 ______ KwH @ Tier 1 Rate ___________

Tier 2 ______ KwH @ Tier 2 Rate ___________ Tier 2 ______ KwH @ Tier 2 Rate ___________

Tier 3 ______ KwH @ Tier 3 Rate ___________ Tier 3 ______ KwH @ Tier 3 Rate ___________

Tier 4 ______ KwH @ Tier 4 Rate ___________ Tier 4 ______ KwH @ Tier 4 Rate ___________

All Over Tier 4 @ Tier 5 Rate ___________ All Over Tier 4 @ Tier 5 Rate ___________

Other Charges (Year Round):

Base Rate/Service Fee/Minimum Fee/Flat Rate Per Month ________________

Additional/Surcharges Per KwH _______________________________ _________________

Taxes Per KwH_____________________ Taxes Percent ________________%

Natural Gas Utility Company Name ____________________________________ Not Available

Phone/Web______________________________________________

Comments/ Contact Name_______________________________________________________________

Method 1: Cost to Residential Customers: (average summer/winter rates if applicable; include all taxes) 50 Therms____________ 100 Therms___________ 150 Therms___________ 200 Therms___________ (1 Therm = 1 CCF = 100 CF. 10 Therms = 10 CCF = 1,000 CF = 1 MCF)

Method 2: Contractor can enter into iQMIS the following cost components:

Natural Gas Units and Rates are published by: Therm CCF MCF

Summer/Year-Round (_______Months) Winter (________Months)

Tier 1 ______ Units @ Tier 1 Rate ___________ Tier 1 ______ Units @ Tier 1 Rate ___________

Tier 2 ______ Units @ Tier 2 Rate ___________ Tier 2 ______ Units @ Tier 2 Rate ___________

Tier 3 ______ Units @ Tier 3 Rate ___________ Tier 3 ______ Units @ Tier 4 Rate ___________

Tier 4 ______ Units @ Tier 4 Rate ___________ Tier 4 ______ Units @ Tier 5 Rate ___________

All Over Tier 4 Units @ Tier 5 Rate __________ All Over Tier 4 Units @ Tier 5 Rate __________

Other Charges (Year-Round):

Base Rate/Service Fee/Minimum Fee Per Month $___________ (optional -- includes ____________Units)

Additional Flat Rate Service Fee Per Month $______________

Additional/Surcharges Per Unit________________________ __________

Taxes Per Unit_____________________

Taxes/Additional Percent ____________%

Water Utility Company Name _______________________________________ Not Available (Wells)

Copy of rate sheets required Phone, Web____________________________________________

Comments/ Contact Name_______________________________________________________________

Method 1: Cost to Residential Customers: (average summer/winter rates if applicable; include all taxes) 3,000 gals.____________ 5,000 gals.___________ 7,500 gals.___________ 10,000 gals.___________

(1 cu ft = 7.48 gals. 100 cu ft = 748 gals. 100 cu ft = 1 CCF)

Method 2: Contractor can enter into iQMIS the following cost components:

Water Units and Rates are published by: Gallon CF CCF Summer/Year-Round (_______Months) Winter (________Months)

Tier 1 ______ Units @ Tier 1 Rate ___________ Tier 1 ______ Units @ Tier 1 Rate ___________

Tier 2 ______ Units @ Tier 2 Rate ___________ Tier 2 ______ Units @ Tier 2 Rate ___________

Tier 3 ______ Units @ Tier 3 Rate ___________ Tier 3 ______ Units @ Tier 4 Rate ___________

Tier 4 ______ Units @ Tier 4 Rate ___________ Tier 4 ______ Units @ Tier 5 Rate ___________

All Over Tier 4 Units @ Tier 5 Rate __________ All Over Tier 4 Units @ Tier 5 Rate __________

Other Charges (Year-Round):

Base Rate/Service Fee/Minimum Fee Per Month $___________ (optional -- includes ____________Units)

Additional Flat Rate Service Fee Per Month $______________

Additional Surcharges Per Unit___________________ _________

Taxes Per Unit_____________________

Taxes/Additional Percent ____________%

Sewer Utility Company Name _______________________________________ Not Available (Septic)

Phone, Web____________________________________________

Comments/ Contact Name_______________________________________________________________

Method 1: Cost to Residential Customers: (average summer/winter rates if applicable; include all taxes) 3,000 gals.____________ 5,000 gals.___________ 7,500 gals.___________ 10,000 gals.___________

(1 cu ft = 7.48 gals. 100 cu ft = 748 gals. 100 cu ft = 1 CCF)

Method 2: Contractor can enter into iQMIS the following cost components:

Sewer Units and Rates are published by: Gallon CF CCF Summer/Year-Round (_______Months) Winter (________Months)

Tier 1 ______ Units @ Tier 1 Rate ___________ Tier 1 ______ Units @ Tier 1 Rate ___________

Tier 2 ______ Units @ Tier 2 Rate ___________ Tier 2 ______ Units @ Tier 2 Rate ___________

Tier 3 ______ Units @ Tier 3 Rate ___________ Tier 3 ______ Units @ Tier 4 Rate ___________

Tier 4 ______ Units @ Tier 4 Rate ___________ Tier 4 ______ Units @ Tier 5 Rate ___________

All Over Tier 4 Units @ Tier 5 Rate __________ All Over Tier 4 Units @ Tier 5 Rate __________

Other Charges (Year-Round):

Base Rate/Service Fee/Minimum Fee Per Month $___________ (optional -- includes ____________Units)

Additional Flat Rate Service Fee Per Month $______________

Additional Surcharges Per Unit___________________ _________

Taxes Per Unit_____________________ (taxes usually do not apply to sewer charges)

Taxes/Additional Percent ____________% (taxes usually do not apply to sewer charges)

Garbage Collection Company Name___________________________________ Not Available

Phone, Web______________________________ Incl. in Property Taxes

Contact Name/Comments_______________________________________________________________

Rate Per Month $____________________ include recycling, yard debris, mosquito control, and other charges that are typically included in the monthly garbage fee. Assume 2 cans per week or one 65 gal. can

Propane Company #1 Name ____________________________________ Not Available

Contact Name, Phone, Web________________________________________________

Rate Per Gal. $________________ (include taxes)

Propane Company #2 Name (if available) _____________________________________________

Rate Per Gal. $________________ (include taxes)

Fuel Oil Company #1 Name____________________________________ Not Available

Rate Per Gal. $________________ (include taxes)

Fuel Oil Company #2 Name (if available) ____________________________________

Contact Name, Phone, Web_______________________________________________

Rate Per Gal. $_______________ (include taxes)

File details come from the government source that posted it. Updated Jan 22, 2021.