Attachment J.8a_Estimate at Completion Sample for Cost Reimbursement (CR) CLINSLIN Contract Type.xlsx
XLSX spreadsheet 38 KB Posted
- Solicitation number
- 75FCMC25RJ018
About this file
This file is a Microsoft Excel template for tracking Estimate at Completion (EAC) reporting for cost reimbursement contract line items (CLINs/SLINs). The template includes detailed instructions for contractors to report actual incurred costs, estimates to complete, and various cost categories including direct labor, fringe benefits, overhead, other direct costs (ODCs), G&A, and fee components.
The file contains multiple worksheets with sample data for contract number 75FCMC19C0018 held by Novitas Solutions, Inc., including reports for QIC Demo SLIN 0034 (period of performance 6/1/2020-12/31/2021) and COVID Letter SLIN 0044 (period of performance 12/13/2021-3/31/2022). The template requires contractors to track costs across fiscal years, apply appropriate indirect rates, and calculate variances between estimated completion costs and contract values. This is primarily a reporting template that does not specify required products or services.
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Instructions
| INSTRUCTIONS FOR COST REIMBURSEMENT CLIN/SLIN | |
| 1 | Adjust Cost Category (Column A) to align with your company's specific cost accounting structure. |
| 2 | If Column A was changed, adjust formulas accordingly. Make sure to edit/insert formulas and that all formulas are fully functioning when submitted. CMS should be able to view the formula to determine how the fields were calculated. |
| 3 | Enter period of performance for CLIN/SLIN in Column G, row 1. |
| 4 | Enter period of performance covered as indicated in red in Columns B, C and D, row 3. |
| 5 | Columns A, B, C and D are to be completed by Contractor. Column E has formulas to calculate totals from other columns. |
| 6 | Enter actual incurred cost to date in Column B for the period of performance of the specific CLIN. If that covers more than one Contractor accounting/fiscal year, separate the costs in to 2 periods (to align with fiscal year) and use both Column B and C. |
| 7 | Enter the estimate to complete the remaining work for that CLIN/SLIN in Column C. |
| 8 | Provide all indirect rates used per column in the designated space, rows 31-37 as applicable. |
| 9 | Enter contractor's accounting/fiscal year in the designated space in Column B, row 39. |
| 10 | Indicate Contractor's Fiscal Year period as indicated in red in Columns B, C and D, row 30. |
| 11 | If reporting on more than one CLIN or SLIN, make a copy of the CLIN 0001 template worksheet/tab for each and keep them all in this one workbook/spreadsheet. Rename the worksheet/tab appropriately as well as Cells A1 and B1. |
| Columns F and G are for CMS use. |
| Do not lock or password protect spreadsheet. |
CLIN 0001
CLIN 0001 Period of Performance: [Dates]
Cost Category Cumulative Incurred Cost to Date*
[enter applicable dates for period of performance covered for these costs] Cumulative Incurred Cost to Date*
[enter applicable dates for period of performance covered for these costs] Anticipated Estimate to Complete Work Through End of Period of Performance
[enter applicable dates for period of performance covered for these costs] Total Estimate at Completion (EAC) of Period of Performance Total Value per CLIN** Difference Between EAC and CLIN Value**
(positive is underrun, negative is overrun) Col. B+C+D Col. F-E
| Direct Labor | 15,000.00 | 2,000.00 | 50,000.00 | 67,000.00 |
| Fringe (rate identified below) | 3,000.00 | 420.00 | 9,500.00 | 12,920.00 |
| Subottal Labor with Fringe | 18,000.00 | 2,420.00 | 59,500.00 | 79,920.00 |
| Overhead (rate identified below) | 3,960.00 | 556.60 | 12,495.00 | 17,011.60 |
| Subtotal Labor/Fringe/OH | 21,960.00 | 2,976.60 | 71,995.00 | 96,931.60 |
| ODCs | ||||
| Subcontractor | 1,000.00 | 500.00 | 3,000.00 | 4,500.00 |
| Travel | 500.00 | 100.00 | 2,000.00 | 2,600.00 |
| Subtotal ODCs | 1,500.00 | 600.00 | 5,000.00 | 7,100.00 |
Subtotal Direct Costs 23,460.00 3,576.60 76,995.00 104,031.60
G&A (rate identified below) 3,519.00 500.72 12,319.20 16,338.92
Total Costs: 26,979.00 4,077.32 89,314.20 120,370.52 125,000.00 4,629.48
| Award Fee | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Base Fee | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
| Fixed Fee (rate identified below) | 1,348.95 | 203.87 | 4,465.71 | 6,018.53 | 6,250.00 | 231.47 |
TOTAL 28,327.95 4,281.19 93,779.91 126,389.05 131,250.00 4,860.95
RATES: Actual End of Year Rate Used for Column Above
[enter applicable Fiscal Year date] Actual End of Year Rate Used for Column Above
[enter applicable Fiscal Year date] Anticipated End of Year Rate Used for Column Above
[enter applicable Fiscal Year date]
| Fringe | 20% | 21% | 19% |
| Overhead | 22% | 23% | 21% |
| G&A | 15% | 14% | 16% |
| Award Fee | |||
| Base Fee | |||
| Fixed Fee | 5% | 5% | 5% |
| Contractor's Accounting/Fiscal Year: | [enter dates] |
| *Period of Performance may cover more than one Contractor Accounting/Fiscal Year. Separate Column B and C to clearly indicate costs per Fiscal Year. It is understood that different rates may apply. | |
| **Columns F and G are for CMS use. |
&"Times New Roman,Regular"&8EAC Report ver.3
JH 0034 QIC
| Monthly Reporting Period: | May 2022 | MAC Jurisdiction: | Jurisdiction H | Date of Report: | 6/23/22 | ||||||
| MAC ESTIMATE AT COMPLETION (EAC) REPORT | Period of Performance (contract dates) | 6/01/2020-12/31/2021 | Contract Number: | 75FCMC19C0018 | |||||||
| SLIN: | 0034 QIC DEMO | Contractor Name: | Novitas Solutions, Inc. | ||||||||
| Approved By: | Jonathan Hogan | ||||||||||
| Expenditure Category | Cumulative Incurred Cost at End of Prior Month | Incurred Cost--Current Reporting Period | Cumulative Incurred Cost to Date | Estimated Additional Cost to Complete (ETC) at end of Period of Performance | Estimated Total Cost at Completion (EAC) of Period of Performance | Total SLIN value per Schedule B (TS/SB) as of the Date of This Report | EAC Variance (Over)* or Under TS/SB at end of Period of Performance | EAC % Variance (Over) or Under TS/SB at end of Period of Performance | Total Amount Funded at end of Period of Performance | EAC Variance Over or (Under)** Funded Amount at end of Period of Performance | EAC % Variance Over or (Under) Funded Amount at end of Period of Performance |
| Col. B+C | Col. D+E | Col. F-G | Col. H/G | Col. J-F | Col. K/J | ||||||
| A | B | C | D | E | F | G | H | I | J | K | L |
Direct Labor $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 0.0%
Fringe - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Travel - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Subcontractor Labor - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Subcontractor Direct - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Other Direct Costs - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Overhead - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
G&A - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Interorg - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Adjustment - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Total Expenditures - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0% - 0 - 0 0.0%
| Base Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
| Fixed Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
| Award Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
(Less) Complimentary Credits - 0 - 0 - 0 - 0 - 0 0.0% - 0 0.0%
| TOTALS | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.0% | $ - 0 | $ - 0 | 0.0% |
| ERROR:#DIV/0! | Current Cumulative Incurred Cost to Date as a Percentage of Funding To Date (Col. D / Col. J) |
* (Over) in columns H & I means SLIN value needs to be increased, or the scope decreased ** (Under) in columns K & L means contractor requires incremental funding up to the SLIN value
Cost Variance Explanations:
Direct Labor: The Estimate at Completion for labor was decreased due to lower than expected workload for QIC Demo.
Fringe: Billed fringe cost is lower due to decreased fringe on the direct labor.
Travel: The variance in this cost element is below the 10% threshold.
Subcontractor Labor: The variance in this cost element is below the 10% threshold.
Subcontractor Direct: The variance in this cost element is below the 10% threshold.
Other Direct Costs: The variance in this cost element is below the 10% threshold.
Overhead Costs: Decreased Overhead costs on the direct labor and fringe cost above.
G&A: Decreased G&A costs on the Direct Labor, Fringe, and Indirect cost above.
JH 0044 COVID LTR
| Monthly Reporting Period: | May 2022 | MAC Jurisdiction: | Jurisdiction H | Date of Report: | 6/23/22 | ||||||
| MAC ESTIMATE AT COMPLETION (EAC) REPORT | Period of Performance (contract dates) | 12/13/2021-3/31/2022 | Contract Number: | 75FCMC19C0018 | |||||||
| SLIN: | 0044 COVID Letter | Contractor Name: | Novitas Solutions, Inc. | ||||||||
| Approved By: | Jonathan Hogan | ||||||||||
| Expenditure Category | Cumulative Incurred Cost at End of Prior Month | Incurred Cost--Current Reporting Period | Cumulative Incurred Cost to Date | Estimated Additional Cost to Complete (ETC) at end of Period of Performance | Estimated Total Cost at Completion (EAC) of Period of Performance | Total SLIN value per Schedule B (TS/SB) as of the Date of This Report | EAC Variance (Over)* or Under TS/SB at end of Period of Performance | EAC % Variance (Over) or Under TS/SB at end of Period of Performance | Total Amount Funded at end of Period of Performance | EAC Variance Over or (Under)** Funded Amount at end of Period of Performance | EAC % Variance Over or (Under) Funded Amount at end of Period of Performance |
| Col. B+C | Col. D+E | Col. F-G | Col. H/G | Col. J-F | Col. K/J | ||||||
| A | B | C | D | E | F | G | H | I | J | K | L |
Direct Labor $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 0.0%
Fringe - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Travel - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Subcontractor Labor - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Subcontractor Direct - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Other Direct Costs - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Overhead - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
G&A - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Interorg - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Adjustment - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0%
Total Expenditures - 0 - 0 - 0 - 0 - 0 - 0 - 0 0.0% - 0 - 0 0.0%
| Base Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
| Fixed Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
| Award Fee | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | 0.0% | - 0 | - 0 | 0.0% |
(Less) Complimentary Credits - 0 - 0 - 0 - 0 - 0 0.0% - 0 0.0%
| TOTALS | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.0% | $ - 0 | $ - 0 | 0.0% |
| ERROR:#DIV/0! | Current Cumulative Incurred Cost to Date as a Percentage of Funding To Date (Col. D / Col. J) |
* (Over) in columns H & I means SLIN value needs to be increased, or the scope decreased ** (Under) in columns K & L means contractor requires incremental funding up to the SLIN value
Cost Variance Explanations:
Direct Labor: The variance in this cost element is below the 10% threshold.
Fringe: The variance in this cost element is below the 10% threshold.
Travel: The variance in this cost element is below the 10% threshold.
Subcontractor Labor: The variance in this cost element is below the 10% threshold.
Subcontractor Direct: The variance in this cost element is below the 10% threshold.
Other Direct Costs: The variance in this cost element is below the 10% threshold.
Other Direct Costs: The variance in this cost element is below the 10% threshold.
G&A: The variance in this cost element is below the 10% threshold.
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