Attachment 13 - Breakdown of Proposed Estimated Costs.xlsx

XLSX spreadsheet 125 KB Posted Feb 1, 2024

Attached to: Interventional Agents Chemistry Services
Solicitation number: 75N93024R00002
Issued by: Department of Health and Human Services National Institutes of Health National Institute of Allergy and Infectious Diseases

About this file

Written by GovTribe AI · Feb 1, 2024

This solicitation requests proposals for Interventional Agents Chemistry Services, to be awarded as multiple Indefinite Delivery/Indefinite Quantity contracts by the National Institute of Allergy and Infectious Diseases. The services include non-GMP chemistry, GMP manufacturing and formulation of drug substances and products to support development of therapeutic candidates against potential bioterrorism agents, drug-resistant pathogens, and infectious diseases. Non-GMP chemistry includes route optimization, process development and synthesis. GMP services include formulation development, cGMP synthesis of drug substance, cGMP manufacturing of drug product, documentation for IND filing, and product release and stability testing required for clinical trials. Proposals are due by [DATE] and awards will be made to organizations demonstrating capability to fulfill requirements of Task Area B for non-GMP chemistry or Task Area C for GMP services. The focus is on discrete small molecule drugs derived from fermentation; biological drugs and complex mixtures are excluded.

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Attachment 17 - NIH(RC)-4.pdf	PDF	Feb 1, 2024
Attachment 14 - Offerors Point-of-Contact.pdf	PDF	Feb 1, 2024
Attachment 8 - Techical Proposal Cost Summary.pdf	PDF	Feb 1, 2024
Attachment 5 - Additional Technical Proposal Instructions.pdf	PDF	Feb 1, 2024
Attachment 16 - NIH(RC)-2.pdf	PDF	Feb 1, 2024
Attachment 12 - HHS Subcontracting Plan Template.pdf	PDF	Feb 1, 2024
Attachment 18 - NIH 2706.pdf	PDF	Feb 1, 2024
Attachment 11 - Proposal Summary and Data Record NIH2043.pdf	PDF	Feb 1, 2024
Attachment 9 - Summary Related Activities.pdf	PDF	Feb 1, 2024
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RFP IACS 75N93024R00002.pdf	PDF	Feb 1, 2024
Attachment 20 - HHSAR 352.223-70 Safety and Health.pdf	PDF	Feb 1, 2024
Attachment 19 - Instructions for NIH 2706.pdf	PDF	Feb 1, 2024
Attachment 15 - Disclosure of Lobbying Activities.pdf	PDF	Feb 1, 2024

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INSTRUCTIONS

OMB Control No. 9000-0013

How to use this Excel file:

(Updated 08/06/2014)

IMPORTANT NOTE: If you have opened this file before saving on your computer, you will be prompted for a user name and a password and you will lose all the data you may have inserted. Please close the file and click on the link again and save before opening.

This worksheet is intended to help you prepare your cost proposal. If you provide us with an electronic copy of the cost proposal, we can save time by not recreating it. This will help speed up the review/award process and perhaps reduce the number of questions we need to ask in order to understand your proposal. We understand that one spreadsheet format can not fit every situation; however, we have attempted to create a simple model that fits most circumstances that arise in Government contracting. Feel free to modify the spreadsheet to fit your circumstances, and to use the parts that work for you. There are more specific instructions on specific cost element pages where applicable.

Summary Page

Please insert your organization's name in cell A2 and the RFP No. in cell A3.

The totals from each cost element page are automatically carried forward to the Summary worksheet. Enter the start date of the contract in cell C5.

This Excel file is set up for seven periods.

Direct Labor

Use the Labor - Percent of Effort worksheet if you track labor on a percent of effort basis. Generally, Universities, Hospitals, and Non-Profit Organizations tract labor by percent of effort.

Use the Labor - Hourly worksheet if you track labor on an hourly basis. Commercial organizations track labor on an hourly basis.

Use both pages if you track some employees by each method. Please do not put any employee on both pages. Consultants should be proposed on the consultants worksheet, not the labor worksheets.

The proposed amounts must be based on current payroll information which shows hourly, monthly, or annual rate/salary for each proposed (named) individuals. Acceptable documentation includes any one of the following: 1) personnel action forms, or 2) most recent payroll register showing name, pay rate, and percent of effort if applicable, or 3) copy of pay stub. Supporting documentation may be requested at a later date.

If the proposed positions have not been filled or are to be named or hired, then acceptable documentation includes the following: 1) letter of intent to hire including salary rate and title, or 2) position descriptions and salary scales or organizational wage table showing salary range and a copy of hiring policy, or 3) a comparable employee's payroll document. Supporting documentation may be requested at a later date. Increases for the to be named or hired are not eligible for increases in the first period.

Indirect Rates Including Fringe Benefit Rate(s) for Commercial Organizations

If your organization does not have negotiated rates, the following website contains information which will assist you in computing indirect rates: http://oamp.od.nih.gov/dfas/indirect-cost-branch/indirect-cost-submission

Please do not submit your indirect proposal to the Division of Financial Advisory Services at this time.

Points of Contact

If you have any questions regarding this Excel file, please see the DFAS Subject Matter Advisors page for contact info: http://oamp.od.nih.gov/dfas/dfas-subject-matter-advisors

If you have contracting questions, please call the NIH Contracting Official who is listed in the RFP.

http://oamp.od.nih.gov/dfas/dfas-subject-matter-advisorshttp://oamp.od.nih.gov/dfas/dfas-subject-matter-advisors

SUMMARY

SUMMARY OF PROPOSED COSTS
Contractor's Name**
RFP No.**
		PERIOD I	PERIOD II	PERIOD III	PERIOD IV	PERIOD V	PERIOD VI	PERIOD VII	TOTAL
	Period ( dates)##	1/1/07	1/1/08	1/1/09	1/1/10	1/1/11	1/1/12	1/1/13
		Through	Through	Through	Through	Through	Through	Through
		12/31/07	12/31/08	12/31/09	12/31/10	12/31/11	12/31/12	12/31/13
Direct Labor - Percent of Effort		$0	$0	$0	$0	$0	$0	$0	$0
Fringe Benefits - Percent of Effort		0	0	0	0	0	0	0	0
Direct Labor - Hourly		0	0	0	0	0	0	0	0
Fringe Benefits - Hourly		0	0	0	0	0	0	0	0
Total Direct Labor & Fringe Benefits		$0	$0	$0	$0	$0	$0	$0	$0

Overhead (Note 1) 0% $0 0% $0 0% $0 0% $0 0% $0 0% $0 0% $0 $0

Materials and Supplies	$0	$0	$0	$0	$0	$0	$0	$0
Professional Travel	0	0	0	0	0	0	0	0
Equipment	0	0	0	0	0	0	0	0
Consultants	0	0	0	0	0	0	0	0
Other Direct Costs	0	0	0	0	0	0	0	0
Patient Care Costs	0	0	0	0	0	0	0	0
Subcontracts	0	0	0	0	0	0	0	0
Total Other Direct Costs	$0	$0	$0	$0	$0	$0	$0	$0

Subtotal: Direct Labor, Fringe Benefits, Overhead , & Other Directs		$0		$0		$0		$0		$0		$0		$0	$0
Exclusion(s) From Base For G&A		0		0		0		0		0		0		0	0
Adjusted Base for G&A		$0		$0		$0		$0		$0		$0		$0	$0
G&A (Note 2)	0%	0	0%	0	0%	0	0%	0	0%	0	0%	0	0%	0	0
Total Proposed Cost Excluding Fee		0		0		0		0		0		0		0	0
Proposed Fee/Profit	0%	0	0%	0	0%	0	0%	0	0%	0	0%	0	0%	0	0
Total Proposed Cost Plus Fee/Profit		$0		$0		$0		$0		$0		$0		$0	$0

NOTES:
1.	Not all organizations allocate indirect cost in the same way. It is important that you use the indirect rate structure applicable to your organization.
	For example, if you have a two tier indirect rate structure, then you will use a two tier structure when proposing indirect costs.
	Generally, Universities and Non-Profits have fringe benefit and G&A (or sometimes called F&A) rates, while For-Profit Companies can have
	various indirect rates such as fringe benefits, overhead, G&A, etc.

The base for overhead costs includes direct labor and fringe benefits. Please modify if your base is different.

If applicable, insert exclusions to the G&A base in row 26.

2.	If you have questions regarding indirect (F&A) rates see website: http://oamp.od.nih.gov/dfas/indirect-cost-branch/indirect-cost-submission
	This website also contains definitions, examples, and training.

LEGEND:
**	Please insert the Company's name and the RFP #.

## Please insert the Company's name and the RFP #.

LABOR - Percent of Effort

	SUMMARY OF DIRECT LABOR
	AND FRINGE BENEFITS
	PERCENT OF EFFORT
	Contractor's Name**								PERIOD I*					PERIOD II*					PERIOD III*					PERIOD IV*					PERIOD V*					PERIOD VI*					PERIOD VII*
	RFP No.**							1/1/07	Through	12/31/07			1/1/08	Through	12/31/08			1/1/09	Through	12/31/09			1/1/10	Through	12/31/10			1/1/11	Through	12/31/11			1/1/12	Through	12/31/12			1/1/13	Through	12/31/13		TOTAL	TOTAL
				CURRENT	ADJUSTED		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE		PERCENT
OF	NUMBER	SALARY	FRINGE	FRINGE	SALARY	FRINGE
		EMPLOYEE	POSITION	BASE SALARY	BASE SALARY		EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	EFFORT	MONTHS	COST	RATE	COST	COST	COST
	1			$0	$0		0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	0%	12.00	$0	0%	$0	$0	$0
	2			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	3			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	4			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	5			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	6			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	7			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	8			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	9			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	10			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	11			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	12			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	13			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	14			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	15			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	16			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	17			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	18			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	19			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	20			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	21			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	22			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	23			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	24			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	25			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	26			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	27			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	28			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	29			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	30			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
	31			0	0		0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0%	12.00	0	0%	0	0	0
					SUBTOTALS =		0%		$0		$0	0%		$0		$0	0%		$0		$0	0%		$0		$0	0%		$0		$0	0%		$0		$0	0%		$0		$0	$0	$0

THE FOLLOWING BOXES IN COLUMN "D" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual

anniversary dates differ, the adjusted base salaries must be entered individually

in Column "D" of the spreadsheet and explained in the budget justification)

ANNUAL INCREASE FACTOR:	0.00%	-	Insert annual cost of living % and/or merit increases
			as applicable and explain the % in the budget justification

ANNUAL INCREASE DATE: 00/00/00 - Insert annual increase date.

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE 0 - Insert number of months at the new salary.

*Adjust the number of months per period as recommended in the RFP.

LABOR - Hourly

SUMMARY OF DIRECT LABOR
AND FRINGE BENEFITS
Hourly Rates
Contractor's Name**							PERIOD I*					PERIOD II*					PERIOD III*					PERIOD IV*					PERIOD V*					PERIOD VI*					PERIOD VII*
RFP No.**						1/1/07	Through	12/31/07			1/1/08	Through	12/31/08			1/1/09	Through	12/31/09			1/1/10	Through	12/31/10			1/1/11	Through	12/31/11			1/1/12	Through	12/31/12			1/1/13	Through	12/31/13		TOTAL	TOTAL
			CURRENT BASE	ADJUSTED	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	NUMBER	NUMBER	SALARY	FRINGE	FRINGE	SALARY	FRINGE
	EMPLOYEE	POSITION	HOURLY RATE	HOURLY RATE	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	HOURS	MONTHS	COST	RATE	COST	COST	COST
1			$0.00	$0.00	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	0.00	12.00	$0	0%	$0	$0	$0
2			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
3			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
4			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
5			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
6			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
7			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
8			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
9			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
10			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
11			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
12			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
13			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
14			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
15			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
16			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
17			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
18			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
19			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
20			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
21			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
22			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
23			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
24			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
25			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
26			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
27			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
28			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
29			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
30			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
31			0.00	0.00	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0.00	12.00	0	0%	0	0	0
				SUBTOTALS =	0.00		$0		$0	0.00		$0		$0	0.00		$0		$0	0.00		$0		$0	0.00		$0		$0	0.00		$0		$0	0.00		$0		$0	$0	$0

THE FOLLOWING BOXES IN COLUMN "D" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual

anniversary dates differ, the adjusted base salaries must be entered individually in

Column "D" of the spreadsheet and explained in the budget justification)

NUMBER OF HOURS FOR FULL TIME EQUIVALENT: 0 -- Insert your direct work year.

			Insert annual cost of living % and/or merit increases
ANNUAL INCREASE FACTOR:	0.00%	--	as applicable and explain the % in the budget
			justification

ANNUAL INCREASE DATE: 00/00/00 -- Insert annual increase date.

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE 0 -- Insert number of months at the the new hourly rate.

*Adjust the number of months per period as recommended in the RFP.

Materials

SUMMARY OF MATERIALS AND SUPPLIES
Contractor's Name**
RFP No.**
			Period I			Period II			Period III			Period IV			Period V			Period VI			Period VII
		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit
	ITEM	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	TOTAL
1		$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00
2		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
3		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
4		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
5		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
6		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
7		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
8		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
9		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
10		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
11		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
12		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
13		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
14		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
15		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
16		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
17		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
18		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
19		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
20		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
21		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
22		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
23		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
24		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
25		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
26		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
27		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
28		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
29		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
30		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
	TOTAL =			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00	$0.00

Please use current catalog, historical documentation, or vendor quotes.

Supporting documentation may be requested at a later date

&24&USUMMARY OF MATERIALS AND SUPPLIES

Travel

SUMMARY OF TRAVEL COSTS

Contractor's Name**

RFP No.**

Cost Element	Period I	Period II	Period III	Period IV	Period V	Period VI	Period VII	TOTAL
Trip #	1	1	1	1	1	1	1
Site
Reason
Airfare	$0	$0	$0	$0	$0	$0	$0
Lodging	0	0	0	0	0	0	0
Meals	0	0	0	0	0	0	0
Incidentals	0	0	0	0	0	0	0
Ground Transport	0	0	0	0	0	0	0
Total Per Trip	$0	$0	$0	$0	$0	$0	$0
No. of persons	0	0	0	0	0	0	0
SUBTOTAL =	$0	$0	$0	$0	$0	$0	$0	$0

Trip #	2	2	2	2	2	2	2
Site
Reason
Airfare	$0	$0	$0	$0	$0	$0	$0
Lodging	0	0	0	0	0	0	0
Meals	0	0	0	0	0	0	0
Incidentals	0	0	0	0	0	0	0
Ground Transport	0	0	0	0	0	0	0
Total Per Trip	$0	$0	$0	$0	$0	$0	$0
No. of persons	0	0	0	0	0	0	0
SUBTOTAL =	$0	$0	$0	$0	$0	$0	$0	$0

Trip #	3	3	3	3	3	3	3
Site
Reason
Airfare	$0	$0	$0	$0	$0	$0	$0
Lodging	0	0	0	0	0	0	0
Meals	0	0	0	0	0	0	0
Incidentals	0	0	0	0	0	0	0
Ground Transport	0	0	0	0	0	0	0
Total Per Trip	$0	$0	$0	$0	$0	$0	$0
No. of persons	0	0	0	0	0	0	0
SUBTOTAL =	$0	$0	$0	$0	$0	$0	$0	$0
TOTAL COST BY PERIOD =	$0	$0	$0	$0	$0	$0	$0	$0

Please review the RFP for the recommended number of trips and destinations if applicable.

Please use the company or institutional travel policy unless current Government Per Diem rates

are utilized. Please use current vendor quotes for airfare and other travel costs. Supporting

documentation may be requested at a later date.

Equipment

SUMMARY OF EQUIPMENT COSTS
Contractor's Name**
RFP No.**
			Period I			Period II			Period III			Period IV			Period V			Period VI			Period VII
		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit
	ITEM	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	TOTAL
1		$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00
2		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
3		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
4		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
5		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
6		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
7		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
8		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
9		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
10		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
11		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
12		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
13		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
14		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
15		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
16		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
17		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
18		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
19		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
20		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
21		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
22		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
23		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
24		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
25		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
26		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
27		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
28		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
29		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
30		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
	TOTAL =			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00	$0.00

All proposed equipment costs should include a justification and be based on current vendor quotes.

Supporting documentation may be requested at a later date.

&24&USUMMARY OF EQUIPMENT COSTS

Consultants

SUMMARY OF CONSULTANT COSTS

Contractor's Name**

RFP No.**

					Period I					Period II					Period III
	CONSULTANT	Rate	# Hours	# Days	Travel	Subtotal	Rate	# Hours	# Days	Travel	Subtotal	Rate	# Hours	# Days	Travel	Subtotal
(1)		$0			$0	$0	$0			$0	$0	$0			$0	$0
(2)		0			0	0	0			0	0	0			0	0
(3)		0			0	0	0			0	0	0			0	0
(4)		0			0	0	0			0	0	0			0	0
(5)		0			0	0	0			0	0	0			0	0
(6)		0			0	0	0			0	0	0			0	0
(7)		0			0	0	0			0	0	0			0	0
(8)		0			0	0	0			0	0	0			0	0
(9)		0			0	0	0			0	0	0			0	0
(10)		0			0	0	0			0	0	0			0	0
	TOTAL =					$0					$0					$0

					Period IV					Period V
	CONSULTANT	Rate	# Hours	# Days	Travel	Subtotal	Rate	# Hours	# Days	Travel	Subtotal
(1)		$0			$0	$0	$0			$0	$0
(2)		0			0	0	0			0	0
(3)		0			0	0	0			0	0
(4)		0			0	0	0			0	0
(5)		0			0	0	0			0	0
(6)		0			0	0	0			0	0
(7)		0			0	0	0			0	0
(8)		0			0	0	0			0	0
(9)		0			0	0	0			0	0
(10)		0			0	0	0			0	0
	TOTAL =					$0					$0

					Period VI					Period VII
	CONSULTANT	Rate	# Hours	# Days	Travel	Subtotal	Rate	# Hours	# Days	Travel	Subtotal	TOTAL
(1)		$0			$0	$0	$0			$0	$0	$0
(2)		0			0	0	0			0	0	0
(3)		0			0	0	0			0	0	0
(4)		0			0	0	0			0	0	0
(5)		0			0	0	0			0	0	0
(6)		0			0	0	0			0	0	0
(7)		0			0	0	0			0	0	0
(8)		0			0	0	0			0	0	0
(9)		0			0	0	0			0	0	0
(10)		0			0	0	0			0	0	0
	TOTAL =					$0					$0	$0

Please provide a complete breakdown for each consultant with rates for the number hours or days plus any proposed travel

costs (including travel rates). Please obtain a signed letter of commitment which shows the base rate for each consultant.

Supporting doucmentation may be requested at a later date.

Other Direct

SUMMARY OF OTHER DIRECT COSTS

Contractor's Name**

RFP No.**

			Period I			Period II			Period III			Period IV			Period V			Period VI			Period VII
		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit
	ITEM	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	TOTAL
1		$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00
2		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
3		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
4		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
5		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
6		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
7		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
8		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
9		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
10		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
11		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
12		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
13		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
14		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
15		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
16		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
17		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
18		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
19		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
20		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
21		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
22		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
23		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
24		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
25		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
26		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
27		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
28		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
29		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
30		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
	TOTAL =			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00	$0.00

Please use current catalog prices, or vendor quotes.

Supporting documentation may be requested at a later date.

&24&USUMMARY OF OTHER DIRECT COSTS

Patient Care

SUMMARY OF PATIENT CARE COSTS
Contractor's Name**
RFP No.**
			Period I			Period II			Period III			Period IV			Period V			Period VI			Period VII
		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit		Unit	Unit
	ITEM	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	Price	Quantity	Subtotal	TOTAL
1		$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00	0	$0.00	$0.00
2		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
3		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
4		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
5		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
6		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
7		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
8		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
9		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
10		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
11		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
12		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
13		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
14		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
15		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
16		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
17		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
18		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
19		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
20		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
21		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
22		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
23		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
24		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
25		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
26		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
27		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
28		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
29		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
30		0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00	0	0.00	0.00
	TOTAL =			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00			$0.00	$0.00

Please use current institutional costs or vendor quotes. Supporting

documentation may be requested at a later date.

&24&USUMMARY OF PATIENT CARE COSTS

Subcontracts

SUMMARY OF SUBCONTRACTOR COSTS

Contractor's Name**

RFP No.**

	SUBCONTRACT #	Period I	Period II	Period III	Period IV	Period V	Period VI	Period VII	TOTAL
(1)		$0	$0	$0	$0	$0	$0	$0	$0
(2)		0	0	0	0	0	0	0	0
(3)		0	0	0	0	0	0	0	0
(4)		0	0	0	0	0	0	0	0
(5)		0	0	0	0	0	0	0	0
(6)		0	0	0	0	0	0	0	0
(7)		0	0	0	0	0	0	0	0
(8)		0	0	0	0	0	0	0	0
(9)		0	0	0	0	0	0	0	0
(10)		0	0	0	0	0	0	0	0
	TOTAL =	$0	$0	$0	$0	$0	$0	$0	$0
	A complete breakdown and summary sheet for each proposed subcontract must
	be included with the prime proposal. The same format should be used for both
	the prime and subcontract proposals.

File details come from the government source that posted it. Updated Feb 1, 2024.