Attachment BB Estimated Pricing Sheet.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
R499--State Veterans Home (SVH) Nursing Homes
Solicitation number
36C10G24R0016
Issued by

About this file

This is an Estimated Pricing Sheet template for survey and reporting services related to State Veterans Home (SVH) Nursing Homes under solicitation 36C10G24R0016. The pricing sheet is structured across a base period and four additional contract periods, with a final optional period, establishing quantities for various survey types and deliverables.

The sheet itemizes services including Annual Surveys (ranging from 173 to 201 units in full periods), For Cause Surveys (5 units per period), Initial Recognition Surveys (7-9 units), Focused Recognition Surveys (4-8 units), and monthly/quarterly meetings (12 monthly and 4 quarterly per period). Deliverables include quarterly electronic feedback reports, survey deficiency summary reports (ranging from 195 to 217 units across periods), ad hoc reports, annual and quarterly survey schedules, simple reports, survey scripts, project work plans, communication plans, training plans, and an electronic feedback mechanism. The optional fifth period contains reduced quantities at approximately 50% of regular period levels, suggesting a wind-down or partial-year option. All unit prices and amounts are blank in this template, requiring contractors to populate pricing information for each line item and contract period. The sheet provides a framework for estimating total contract value across the full performance period.

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Other files

File Type Posted
36C10G24R0016 0002.docx DOCX document
Past Performance Questionnaire Fillable.pdf PDF
Attachment Z_Survey Deficiency Summary Report Format 01.pdf PDF
Attachment A_SVH Master Survey Schedule Listing 01.pdf PDF
36C10G24R0016 0001.docx DOCX document
Attachment U_ Final Survey Report Format 01.pdf PDF
36C10G24R0016 SVH.pdf PDF
Attachment C Observation Record - informational.pdf PDF
Answers Amendment 1 SVH.pdf PDF
Attachment X_Quick Reference Guide_Domiciliary.pdf PDF
Attachment S_Scope and Severity Matrix.pdf PDF
Attachment H_VA Form 10-0144A.pdf PDF
Attachment C_Observation Record.pdf PDF
Attachment CC Detailed Price Cost Sheet.xlsx XLSX spreadsheet
Attachment W_Quick Reference Guide_Nursing Home.pdf PDF
Attachment P_SVH DOM Large Board and Care Life Safety Checklist.pdf PDF
Attachment O_SVH_DOM_Family Dwellings.pdf PDF
Attachment N_SVH NH_DOM_ADHC_Combine Life Safety Checklist.pdf PDF
Attachment M_SVH NH_DOM_Combine Life Safety Checklist.pdf PDF
Attachment K_VA NFPA Interpretation for the SVH Program.pdf PDF
Attachment I_ VA Form 10-3567 Staffing Profile.pdf PDF
Attachment F_VA Form 10-0143A.pdf PDF
Attachment D_Table of Surveyor Component Guide.pdf PDF
Attachment Z_Survey Deficiency Summary Report Format.pdf PDF
Attachment Y_Quick Reference Guide_ADHC.pdf PDF
Attachment R_Existing Day Care Occupancy Checklist.pdf PDF
Attachment Q_SVH DOM Small Board and Care Life Safey Checklist.pdf PDF
Attachment G_VA Form 10-0144.pdf PDF
Attachment E_VA Form 10-0143.pdf PDF
Attachment A_SVH Master Survey Scheduling Listing.pdf PDF
36C10G24R0016.pdf PDF
36C10G24R0016.docx DOCX document
Attachment AA -Business Associate Agreement.docx DOCX document
Attachment V_Life Safety Code Headings.pdf PDF
Attachment U_ Final Survey Report Format.pdf PDF
Attachment T_IJ Template.pdf PDF
Attachment L_SVH NH_Life Safety Checklist.pdf PDF
Attachment J_VA Form 10-3567 Staffing Profile Reference.pdf PDF
Attachment B_Corrective Action Request Procedure and Form.pdf PDF
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Text version

Sheet1

ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001Annual Surveys173EA$ - 0$ - 0
0002For Cause Survey5EA$ - 0$ - 0
0003Initial Recognition Survey9EA$ - 0$ - 0
0004Focused Recognition Survey8EA$ - 0$ - 0
0005Kick off Meeting1EA$ - 0$ - 0
0006Monthly Meeting12EA$ - 0$ - 0
0007Quarterly Meeting4EA$ - 0$ - 0
0008Quartley Electronic Feedback Reports4EA$ - 0$ - 0
0009Survey Deficiency Summary Reports195EA$ - 0$ - 0
0010Ad Hoc Reports3EA$ - 0$ - 0
0011Annual Survey Schedules1EA$ - 0$ - 0
0012Quarterly Survey Schedules4EA$ - 0$ - 0
0013Simple Report5EA$ - 0$ - 0
0014Survey Script1EA$ - 0$ - 0
0015Project Work Plan Updates1EA$ - 0$ - 0
0016Communication Plan1EA$ - 0$ - 0
0017Contractor Personnel Training Plan1EA$ - 0$ - 0
0018Electronic Feedback Mechanism1EA$ - 0$ - 0
BASE TOTAL$ - 0
1001Annual Surveys180EA$ - 0$ - 0
1002For Cause Survey5EA$ - 0$ - 0
1003Initial Recognition Survey9EA$ - 0$ - 0
1004Focused Recognition Survey4EA$ - 0$ - 0
1005Kick off Meeting1EA$ - 0$ - 0
1006Monthly Meeting12EA$ - 0$ - 0
1007Quarterly Meeting4EA$ - 0$ - 0
1008Quarterly Electronic Feedback Reports4EA$ - 0$ - 0
1009Survey Deficiency Summary Reports198EA$ - 0$ - 0
1010Ad Hoc Reports3EA$ - 0$ - 0
1011Annual Survey Schedules1EA$ - 0$ - 0
1012Quarterly Survey Schedules4EA$ - 0$ - 0
1013Simple Report5EA$ - 0$ - 0
PERIOD 1 TOTAL$ - 0
2001Annual Surveys186EA$ - 0$ - 0
2002For Cause Survey5EA$ - 0$ - 0
2003Initial Recognition Survey9EA$ - 0$ - 0
2004Focused Recognition Survey4EA$ - 0$ - 0
2005Kick off Meeting1EA$ - 0$ - 0
2006Monthly Meeting12EA$ - 0$ - 0
2007Quarterly Meeting4EA$ - 0$ - 0
2008Quarterly Electronic Feedback Reports4EA$ - 0$ - 0
2009Survey Deficiency Summary Reports204EA$ - 0$ - 0
2010Ad Hoc Reports3EA$ - 0$ - 0
2011Annual Survey Schedules1EA$ - 0$ - 0
2012Quarterly Survey Schedules4EA$ - 0$ - 0
2013Simple Report5EA$ - 0$ - 0
PERIOD 2 TOTAL$ - 0
3001Annual Surveys195EA$ - 0$ - 0
3002For Cause Survey5EA$ - 0$ - 0
3003Initial Recognition Survey7EA$ - 0$ - 0
3004Focused Recognition Survey4EA$ - 0$ - 0
3005Kick off Meeting1EA$ - 0$ - 0
3006Monthly Meeting12EA$ - 0$ - 0
3007Quarterly Meeting4EA$ - 0$ - 0
3008Quarterly Electronic Feedback Reports4EA$ - 0$ - 0
3009Survey Deficiency Summary Reports211EA$ - 0$ - 0
3010Ad Hoc Reports3EA$ - 0$ - 0
3011Annual Survey Schedules1EA$ - 0$ - 0
3012Quarterly Survey Schedules4EA$ - 0$ - 0
3013Simple Report5EA$ - 0$ - 0
PERIOD 3 TOTAL$ - 0
4001Annual Surveys201EA$ - 0$ - 0
4002For Cause Survey5EA$ - 0$ - 0
4003Initial Recognition Survey7EA$ - 0$ - 0
4004Focused Recognition Survey4EA$ - 0$ - 0
4005Kick off Meeting1EA$ - 0$ - 0
4006Monthly Meeting12EA$ - 0$ - 0
4007Quarterly Meeting4EA$ - 0$ - 0
4008Quarterly Electronic Feedback Reports4EA$ - 0$ - 0
4009Survey Deficiency Summary Reports217EA$ - 0$ - 0
4010Ad Hoc Reports3EA$ - 0$ - 0
4011Annual Survey Schedules1EA$ - 0$ - 0
4012Quarterly Survey Schedules4EA$ - 0$ - 0
4013Simple Report5EA$ - 0$ - 0
PERIOD 4 TOTAL$ - 0
5001Annual Surveys100EA$ - 0$ - 0
5002For Cause Survey2EA$ - 0$ - 0
5003Initial Recognition Survey3EA$ - 0$ - 0
5004Focused Recognition Survey2EA$ - 0$ - 0
5005Kick off Meeting1EA$ - 0$ - 0
5006Monthly Meeting6EA$ - 0$ - 0
5007Quarterly Meeting2EA$ - 0$ - 0
5008Quarterly Electronic Feedback Reports2EA$ - 0$ - 0
5009Survey Deficiency Summary Reports107EA$ - 0$ - 0
5010Ad Hoc Reports1EA$ - 0$ - 0
5011Annual Survey Schedules1EA$ - 0$ - 0
5012Quarterly Survey Schedules2EA$ - 0$ - 0
5013Simple Report2EA$ - 0$ - 0
PERIOD 5 TOTAL$ - 0
GRAND TOTAL$ - 0

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