Attachment J.23 - Facilities Capital Cost of Money Factors Computation Template.pdf

PDF 53 KB Posted

Attached to
World Trade Center Health Program Clinical Centers of Excellence (CCE)
Solicitation number
75D301-22-R-72142
Issued by

About this file

This document provides details for the World Trade Center Health Program Clinical Centers of Excellence solicitation. The National Institute for Occupational Safety and Health intends to competitively award cost-reimbursement contracts of five to eight years to provide limited health care delivery services to responders and survivors of the 9/11 attacks. Services include contract management and implementation, quality assurance controls to prevent fraud and abuse, member services and outreach, care coordination and case management, program communications, administering health care services such as monitoring, screening and treatment, and coordination of benefits. Offerors are to regularly check the website for any amendments to the solicitation released after the original posting, as no telephone or written requests will be accepted. Questions must be submitted by email using the provided template, as questions by phone will not be accepted.

View the file

Other files

File Type Posted
75D301-22-R-72142 Revision 06-28-2022.doc DOC document
Questions and Answers 75D301-22-R-72142 complete corrected 06-10-2022.xlsx XLSX spreadsheet
Attachment J.16 - Invoice Format Updated.xlsx XLSX spreadsheet
75D301-22-R-72142 Revision 06-07-2022.doc DOC document
Attachment J.28 - Lifestyle Medicine SOP (Draft).pdf PDF
Attachment J.22 - Business Proposal Format Updated.xlsx XLSX spreadsheet
Questions and Answers 75D301-22-R-72142 complete.xlsx XLSX spreadsheet
75D301-22-R-72142 Revision 05-25-2022.doc DOC document
Attachment J.13 - HHS Subcontracting Plan Template.doc DOC document
Attachment J.25 - NYMA Member Volumes and Acuity.xlsx XLSX spreadsheet
Attachment J.12 - PastPresent Performance Questionnaire.docx DOCX document
Attachment J.9 - TGD 009 (Monthly Report).pdf PDF
Attachment J.14 - CUI-SSP (System Security Plan).docx DOCX document
Attachment J.18 - Change Request Control Log.xlsx XLSX spreadsheet
Attachment J.4 - TGD 003 (Semiannual Report).pdf PDF
Attachment J.20 - Activity_Codes.xlsx XLSX spreadsheet
Attachment J.24 - Case Management & Utilization Management SOP.pdf PDF
Attachment J.26 - Pharmacy Prior Authorizations SOP (Draft).pdf PDF
Attachment J.27 - Provider Blocks SOP (Draft).pdf PDF
Attachment J.19 - Quarterly Staffing Report Template.xlsx XLSX spreadsheet
Attachment J.11 - Partner and Sub Template.xlsx XLSX spreadsheet
Attachment J.15 - Question and Answer Template.xlsx XLSX spreadsheet
Attachment J.8 - TGD 007 (Timely Filing).pdf PDF
Attachment J.7 - BEAST for Responders.pdf PDF
Attachment J.17 - Change_Request_form.docx DOCX document
Attachment J.21 - Billing Labor Categories.xlsx XLSX spreadsheet
75D301-22-R-72142.doc DOC document
Attachment J.6 - BEAST for Survivors (Draft).pdf PDF
Attachment J.10 - Translation Guide.xlsx XLSX spreadsheet
Attachment J.2 - QASP Template.docx DOCX document
Attachment J.16 - Invoice Format May 2022.xlsx XLSX spreadsheet
Attachment J.5 - Transfer Policy.pdf PDF
Attachment J.22 - Business Proposal Format.xlsx XLSX spreadsheet
Attachment J.1 - Acronym List.docx DOCX document
Attachment J.3 - Business Associate Agreement Template.docx DOCX document
Show all 35

On GovTribe

Work with this file

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

Text version

FORM CASB-CMF FACILITIES CAPITAL

COST OF MONEY FACTORS COMPUTATION fcmm.xls

CONTRACTOR: ADDRESS:

BUSINESS UNIT:

1 2 3 4 5 6 7

COST ACCOUNTING PERIOD: Applicable Cost Accumulation & Allocation Total Net Cost of Money Allocation Base Facilities Capital of Direct Distribution of Book for the Cost for the Cost of

Money Rate - ___% of N.B.V. Undistributed Value Accounting Period Period Money Factors

RECORDED

Basis of

Allocation Columns

2 + 3 Columns

1 x 4 In Unit(s) of

Measure Columns

5 ÷ 6

LEASED PROPERTY

CORPORATE OR GROUP

TOTAL

UNDISTRIBUTED

DISTRIBUTED

TOTAL

BUSINESS

UNIT

FACILITIES

CAPITAL

OVERHEAD

POOLS

G&A EXPENSE

POOLS

Contractor:
Business Unit:
Address/1:
Address/2:
Address/3: Note: Provide documentation to support the computation once per period.year.
Rate Percent:
Recorded:
Leased:
Corporate/Group:
Total/1:
Undistributed:
Distributed:
Accumulation/1:
Allocation/1:
Book Value/1:
Cost/1:
Base/1:
FCCMF/1:
Pool/1:
Pool/2:
Accumulation/2:
Book Value/2:
Cost/2:
Base/2:
FCCMF/2:
Pool/3:
Accumulation/3:
Allocation/2:
Allocation/3:
Book Value/3:
Cost/3:
Base/3:
FCCMF/3:
Pool/4:
Accumulation/4:
Allocation/4:
Book Value/4:
Cost/4:
Base/4:
FCCMF/4:
Pool/5:
Accumulation/5:
Allocation/5:
Book Value/5:
Cost/5:
Base/5:
FCCMF/5:
Pool/6:
Accumulation/6:
Allocation/6:
Book Value/6:
Cost/6:
Base/6:
Accumulation/7:
Pool/7:
Allocation/7:
Book Value/7:
Cost/7:
Base/7:
FCCMF/6:
FCCMF/7:
Pool/8:
Accumulation/8:
Allocation/8:
Book Value/8:
Cost/8:
Base/8:
FCCMF/8:
Pool/9:
Accumulation/9:
Allocation/9:
Book Value/9:
Cost/9:
Base/9:
FCCMF/9:
Pool/10:
Accumulation/10:
Allocation/10:
Book Value/10:
Cost/10:
Base/10:
FCCMF/10:
Accu Total:
Allocation Total:
Value Total:
Cost Total:

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