Attachment J.10 - Monthly Invoice Template (West).xlsx

XLSX spreadsheet 43 KB Posted

Attached to
Federal Occupational Health (FOH) Clinical WEST Staffing Solicitation
Solicitation number
PSCFOH-ClinicalWestStaffing-75P00125R00011
Issued by

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The file is a Monthly Invoice Template for a Federal Occupational Health (FOH) Clinical Staffing contract for the West Region. The template is designed for invoicing labor and travel expenses, with specific columns for detailed tracking including employee names, job titles, site codes, cost centers, monthly hours worked, and rates. The invoice covers various nursing and medical support staff positions such as Nurse Coordinators, Staff Nurses/RNs, and Medical Admin Support Staff across multiple locations including Maryland (MD), Virginia (VA), and Washington DC.

The related federal contract opportunity is a total set-aside solicitation (PSCFOH-ClinicalWestStaffing-75P00125R00011) specifically for 8(a) Small Businesses, issued by the Department of Health and Human Services' Program Support Center (PSC) for Federal Occupational Health. The solicitation seeks professional medical staffing and occupational health professionals for the clinical western region, with all questions to be submitted via email to the Contract Specialist Nickita Germany. The contract aims to provide clinical staffing support across various medical professional roles and geographical areas in the western United States.

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Other files

File Type Posted
75P00125R00011_Amendment 0002_7_16_2025.pdf PDF
Attachment J.6-Clinical West Wage Determination List_Amendment 0001.xlsx XLSX spreadsheet
Attachment J.1-Clinical West Pricing Worksheet_Amendment_0001.xlsx XLSX spreadsheet
RFP_75P00125R00011_Clinical West_Amendment 0001_7_7_25.pdf PDF
RFP 75P00125R00011_Clinical West Staffing_7.2.25.pdf PDF
Attachment J.5 - Credential File Format.docx DOCX document
Attachment J.8 - Cumulative Invoice Tracking Template (West).xlsx XLSX spreadsheet
Attachment J.11 - Subcontractor_Team Partner Consent Form.pdf PDF
Attachment J.12 - Client Authorization Letter.pdf PDF
Attachment J.6 - Wage Determination List (West)_Final.xlsx XLSX spreadsheet
Attachment J.7 Contractor Performance Self-Assessment Template.docx DOCX document
Attachment J.4 - Security Clearance and Badging Information (WEST).docx DOCX document
Attachment J.14 Disclosure of Lobbying Activities.pdf PDF
Attachment J.13 - Past Performance Questionaire.docx DOCX document
Attachment J.1-Clinical West Pricing Worksheet_Final.xlsx XLSX spreadsheet
Attachment J.2 - Site Staffing Plan.xlsx XLSX spreadsheet
Attachment J.9 - Contract Transition Incumbent Report (West).xlsx XLSX spreadsheet
Attachment J.3 - Labor Categories.pdf PDF
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INVOICE

ATTACHMENT 7

INVOICE
PLEASE MAIL YOUR REMITTANCE TO:
Contractor's Name, TAX ID Number, Duns Number
Contractor's Address
Contractor's Phone Number
Invoice Date
Invoice #
CONTRACT #
FOR THE PERIOD OF :

LABOR

CAN Site Code State Job Title Cost Center Employee Name ConCat Monthly Hrs Worked Rate Total Due

CLINICAL TOTAL:

TRAVEL

CAN Site Code Description CC Employee Name Date(s) of Travel Total Due

TRAVEL TOTAL:

TOTAL AMOUNT DUE:

Grand Total

MD
Z0YNurse Coordinator ICody, Sharon
A7FNurse Coordinator IGaines, Carol
A7FStaff Nurse/RNWuerstlin, Rebecca
VA
Z3UNurse Coordinator IBurns, Andrea
Occ Health Orientation Hours
DC
A54Staff Nurse/RNHarry, Beverly
A7ENurse Coordinator IRostami, Christine
Z0AMed Admin Support StaffLaw, Schae
Z0GArea Nurse ManagerSharon, Cynthia
MD
A7FStaff Nurse/RNJohnson, Nicole
Z8AStaff Nurse/RNJohnson, Nicole

Page &P

Labor Pivot Table

Travel Pivot Table

File details come from the government source that posted it. Updated .