Attachment 1 - PSC EM Physician Pricing Schedule Template.xlsx
XLSX spreadsheet 29 KB Posted
- Solicitation number
- 75H70426R00007
About this file
This is a Pricing Schedule Template for an Emergency Medicine Physician Personal Services Contract (PSC) with the Indian Health Service. The template is designed to capture pricing information for ad hoc physician services to be provided to the Whiteriver Indian Health Service Hospital's Emergency Department, located within the IHS Phoenix Area Southwest Region, Whiteriver Service Unit. The template serves as the standardized format for vendors to submit their cost proposals in response to Solicitation Number 75H70426R00007.
This is an Indian Small Business Economic Enterprise (ISBEE) set-aside contract, restricting competition to qualifying small businesses. As a template document, it does not contain specific pricing data, response deadlines, or award dates, but rather establishes the required structure and format for bidders to submit their physician service rates and related costs. Interested vendors should refer to the full solicitation package for complete details regarding pricing instructions, submission requirements, evaluation criteria, and contract performance expectations for Emergency Medicine physician services.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 4 - IHSBusinessAssociateAgreement.pdf | ||
| Attachment 2 - Statement of Duties.docx | DOCX document | |
| 75H70426R00007 EM Physician PSC Solicitation.pdf | ||
| Attachment 3 - IEE - Certification Form.pdf |
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Summary
| CLIN | Description | Unit Pricing | Total Not to Exceed Ceiling |
| 0001 | Base Period: Hospital Accreditation & Leadership - Direct Labor | See Pricing Sheet - Attachment 1 – Fixed Hourly Rate Pricing | $9,013,800.00 |
| 0002 | Base Period: Travel - Materials | NTE Ceiling | ERROR:#REF! |
| 0003 | Base Period: Travel Time Compensation | NTE Ceiling | ERROR:#REF! |
| Total | ERROR:#REF! | ||
| 1001 | Option Year 1 : Hospital Accreditation & Leadership - Direct Labor | See Pricing Sheet - Attachment 1 - Fixed Hourly Rate Pricing | $9,216,610.50 |
| 1002 | Option Year 1: Travel - Materials | NTE Ceiling | $ 1,360,000.00 |
| 1003 | Option Year 1: Travel Time Compensation | NTE Ceiling | $210,000.00 |
| Total | $10,786,610.50 | ||
| 2001 | Option Year 2 : Hospital Accreditation & Leadership - Direct Labor | See Pricing Sheet - Attachment 1 - Fixed Hourly Rate Pricing | $9,423,984.24 |
| 2002 | Option Year 2: Travel - Materials | NTE Ceiling | $1,360,000.00 |
| 2003 | Option Year 2: Travel Time Compensation | NTE Ceiling | $210,000.00 |
| Total | $10,993,984.24 | ||
| 3001 | Option Year 3 : Hospital Accreditation & Leadership - Direct Labor | See Pricing Sheet - Attachment 1 - Fixed Hourly Rate Pricing | $9,636,023.88 |
| 3002 | Option Year 3: Travel - Materials | NTE Ceiling | $1,360,000.00 |
| 3001 | Option Year 3: Travel Time Compensation | NTE Ceiling | $210,000.00 |
| Total | $11,206,023.88 | ||
| 4001 | Option Year 4 : Hospital Accreditation & Leadership - Direct Labor | See Pricing Sheet - Attachment 1 - Fixed Hourly Rate Pricing | $9,852,834.42 |
| 4002 | Option Year 4: Travel - Materials | NTE Ceiling | $1,360,000.00 |
| 4003 | Option Year 4: Travel Time Compensation | NTE Ceiling | $210,000.00 |
| Total | $11,422,834.42 | ||
| Total Contract Ceiling Price | ERROR:#REF! |
IGCE
| HHS IGE TEMPLATE | |||||||||||||
| PROJECT TITLE: | |||||||||||||
| Detailed Price Summary | |||||||||||||
| Attachment 1 - Pricing Schedule - Emergency Medicine Physician | |||||||||||||
| CLIN | Base Period | Option Year One | Option Year Two | ||||||||||
| *Unused hours may be carried forward between years, provided that the aggregate total contract ceiling price for all active periods of performance (PoPs) is not exceeded. The estimate represents the estimated maximum number of hours that cold be expended. **Premium pay may be used at the Government's discretion for hard to fill shifts. | FTE | Fixed Hourly rate | Total Est. Hours/Yr* | Unit Price | Total Price | FTE | Total Est. Hours/Yr* | Unit Price | Total Price | FTE | Total Est. Hours/Yr* | Unit Price | Total Price |
| X001 - Direct Labor Regular (Labor Hour) - Personal Services Contractor - Emergency Medicine Physician | 1.00 | 1600 | $ - 0 | $ - 0 | 1.00 | 1600 | $ - 0 | 1.00 | 1600 | $ - 0 | $ - 0 | ||
| X002 - Direct Labor Premium (Labor Hour) - Emergency Medicine Physician** | 1.00 | 75 | $ - 0 | $ - 0 | 1.00 | 75 | $ - 0 | $ - 0 | 1.00 | 75 | $ - 0 | $ - 0 | |
| Subtotal Direct Labor | |||||||||||||
| X003 - Other Direct Costs NTE (Reimbursable at Cost) - Travel, Transportation & Related Expenses * | $ 65,237.00 | $ 65,237.00 | $ 65,237.00 | ||||||||||
| Total Price | $ - 0 | $ - 0 | $ - 0 | ||||||||||
| Total Estimated Yearly Values * | $ 65,237.00 | $ 65,237.00 | $ 65,237.00 | ||||||||||
| TOTAL CONTRACT CEILING PRICE (BASE + OPTIONS) | $ 195,711.00 |
| Assumptions: | Percent |
| Inflation Rate Per Year | 2.25% |
| Fringe Benefits Rate | 0.00% |
| Overhead Rate | 0.00% |
| G&A Rate | 0.00% |
| Fee/Profit Percentage | 0.00% |
| *The contractor is responsible for ensurimg all formulas and calculations are correct. |
| *Unused hours/ceiling may be carried forward between years and/or be realigned between CLINs as necessary (including X003), provided that the aggregate total contract ceiling price for all active periods of performance (PoPs) is not exceeded. |
| ** Hard to fill shifts are determined at the governments discretion. |
&F&D&T
Assumptions Please state any assumptions here, if any.
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