Attachment J104 - Business Proposal Format.xlsx

XLSX spreadsheet 195 KB Posted

Attached to
Solicitation - World Trade Center Health Program - Survivor Clinical Center of Excellence
Solicitation number
CDC-75D301-01-Solicitation-WTCHP
Issued by

About this file

Attachment J104 is a comprehensive Business Proposal Format Excel spreadsheet template for the World Trade Center Health Program Survivor Clinical Center of Excellence (CCE) contract. The detailed template provides a structured format for offerors to propose costs across multiple budget categories and performance periods, including a base period and four option years. The spreadsheet requires granular cost breakdowns for direct labor, subcontract labor, materials, equipment, other direct costs (ODCs), travel, and indirect rates, with specific instructions for differentiating costs between transition-in and start of healthcare delivery/sustainment phases.

The template includes extensive guidance for completing each section, such as specifying exempt/non-exempt labor status, applicable Service Contract Act Wage Determination numbers, labor categories, and activity codes. Offerors must provide detailed cost information including labor rates, annual salaries, effort percentages, productive hours, indirect rates, and fixed fees. The document also includes multiple tabs for documenting costs across different performance periods, with notes emphasizing the need for supporting documentation, pre-approvals for travel, and precise categorization of expenses related to the World Trade Center Health Program's Survivor Clinical Center of Excellence contract.

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Budget Snapshot Date: Summary of Proposed Costs Survivor CCE, Solicitation 75D301-25-R-00088

Budget CategoryBase PeriodOption Yr 1Option Yr 2Option Yr 3Option Yr 4Total
Transition-In PeriodImplementation of Start of Healthcare Delivery & Sustainment
Total Direct Labor$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total Subcontract Labor$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Materials$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Equipment$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Other Direct Costs$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total Direct Costs$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Sub-total$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Indirect Costs (See Note 1)$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Sub-total$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Facilities Capital Cost of Money (FCCOM)$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Sub-total$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Fixed Fee, if proposed$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total Price/Cost for CLIN X001, CCE Operations$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Travel Costs$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Indirect Cost applies to Travel, if applicable$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total Cost for CLIN X002, Travel$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total for CLINs X001 and X002 -
Total Cost/Grand Price)$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0

Note 1: Offerors may add rows to identify each separate proposed indirect costs.

Note 2: Offerors may edit the order of the budget category rows to accurately capture the Offeror's indirect cost applications

Direct Labor Proposed Costs for Base Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1) Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2) PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3) Direct Labor Rate Direct Labor Annual Salary Percentage of Effort / Full-Time Equivalent Productive Hours Direct Charged Non-Productive Hours, if applicable Total Direct Salary for Period (Direct Labor Cost) Subtotal Indirect Rate Identifier/Percentage, e.g Fringe, Overhead, etc. (See Note 4) Labor Adders (See Notes 5) Fixed Fee Total Cost / Grand Total Price Comments

TOTAL (as applicable)

NOTES:

Note 1: Exempt / Non-Exempt Labor – The Offeror shall identify whether a proposed labor category is exempt or non-exempt to the Service Contract Act. The Offeror shall either input “Exempt” or “Non-Exempt,” as applicable.

Note 2: Applicable Service Contract Act (SCA) Wage Determination (WD) Number – The Offeror shall identify the applicable SCA WD number, e.g. WD # 2017-0087, as applicable. Offerors are responsible for determining which SCA WD is applicable to its proposed labor.

Note 3: Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor – The Offeror shall differentiate labor proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and labor proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 4: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Note 5: Labor Adders - If proposed compensation includes more than just basic labor pay (i.e., proposed compensation includes additional items such as bonuses, Service Contract Act requirements, etc.). Depending on the offeror's circumstances and proposal preparation methodology, more than one Labor Adder column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

"Labor Data for Option Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: (enter contract number) "

Subcontract Labor Proposed Subcontract Labor Costs for Base Period: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1 from "Direct Labor Tab") Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2 from "Direct Labor Tab") PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab") Full Burdened Labor Rate Fully Burdened Annual Salary Percentage of Effort / Full-Time Equivalents Productive Hours Total for Period Rate Identifiers / Labor Adders, if applicable (See Note 4 from "Direct Labor" tab) Fixed Fee, if applicable Total cost / Total Price Comments

TOTAL (as applicable)

Totals 0

Activity Report

Activity Codes Aligning to Labor Category for Direct and SubContract Labor CCE: Date for Base Period: XXXX (xx/xx/xx - xx/xx/xx) Note: Labor Category shall match the total reported for Subcontractor and DIrect Labor for each category.
Activity CodesWTC Billing Labor CategoryFTETransition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab")Comments
Total FTE reported0

Rent - Lease Rent/Lease for Option Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: (enter contract number) Provide how Rent/Lease is calculated by completing Attachment 23 (include supporting documentation on original invoice and if a change in rate occurs.

ODC

Proposed Other Direct Costs (ODC) for Base Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Fixed Fee, if applicableTotal Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment ODCs – The Offeror shall differentiate ODCs proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and ODCs proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Materials_Equipment Proposed Materials & Equipment for Base Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Total Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Materials/Equipment – The Offeror shall differentiate materials/equipment proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and materials/equipment proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Travel Travel Expenditures Contract #: TBD Base Period:

All items must have been on proposal or approved in a change request.

Travel requires pre approval documentation.

All items over $5,000 require a receipt.

All travel requires invoices/receipt.

PWS Paragraph CLIN Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel (See Note 1) Destination Duration Purpose Number of Travelers Proposed Airfare Transportation Cost, if applicable Proposed Rental Car Transportation Cost, if applicable Per Diem Subtotal Indirect Rate Identifier (See Note 2) Total Cost

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel – The Offeror shall differentiate travel proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and travel proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS, if applicable. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Indirect Rates Overhead for Base Period: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

Note: G&A, F&A, Fees, and Indirect Rates are to be defined and calculated here.
Allowable Expense Categories:
Facilities Costs (Attachment 23)
Total Expenses0
Overhead Rate
Total Overhead0

Direct Labor (1) Labor Data for Option Period 1: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1) Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2) PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3) Direct Labor Rate Direct Labor Annual Salary Percentage of Effort / Full-Time Equivalent Productive Hours Direct Charged Non-Productive Hours, if applicable Total Direct Salary for Period (Direct Labor Cost) Subtotal Indirect Rate Identifier/Percentage, e.g Fringe, Overhead, etc. (See Note 4) Labor Adders (See Notes 5) Fixed Fee Total Cost / Grand Total Price Comments

TOTAL (as applicable)

NOTES:

Note 1: Exempt / Non-Exempt Labor – The Offeror shall identify whether a proposed labor category is exempt or non-exempt to the Service Contract Act. The Offeror shall either input “Exempt” or “Non-Exempt,” as applicable.

Note 2: Applicable Service Contract Act (SCA) Wage Determination (WD) Number – The Offeror shall identify the applicable SCA WD number, e.g. WD # 2017-0087, as applicable. Offerors are responsible for determining which SCA WD is applicable to its proposed labor.

Note 3: Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor – The Offeror shall differentiate labor proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and labor proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 4: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Note 5: Labor Adders - If proposed compensation includes more than just basic labor pay (i.e., proposed compensation includes additional items such as bonuses, Service Contract Act requirements, etc.). Depending on the offeror's circumstances and proposal preparation methodology, more than one Labor Adder column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Subcontract Labor (1) Subcontract Labor Data for Option Period 1: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1 from "Direct Labor Tab") Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2 from "Direct Labor Tab") PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab") Full Burdened Labor Rate Fully Burdened Annual Salary Percentage of Effort / Full-Time Equivalents Productive Hours Total for Period Rate Identifiers / Labor Adders, if applicable (See Note 4 from "Direct Labor" tab) Fixed Fee, if applicable Total cost / Total Price Comments

TOTAL (as applicable)

Activity Report (1)

Activity Codes Aligning to Labor Category for Direct and SubContract Labor CCE: Date for Option Period 1: XXXX (xx/xx/xx - xx/xx/xx) Note: Labor Category shall match the total reported for Subcontractor and DIrect Labor for each category.
Activity CodesWTC Billing Labor CategoryFTETransition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab")Comments
Total FTE reported0

ODC (1)

Other Direct Costs (ODC) for Option Period 1: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Fixed Fee, if applicableTotal Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment ODCs – The Offeror shall differentiate ODCs proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and ODCs proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Rent - Lease (1) Rent/Lease for Option Period: XXXX (xx/xx/xx - xx/xx/xx)

Provide how Rent/Lease is calculated - Include supporting documentation on original invoice and with each change

Materials_Equipment (1) Materials & Equipment for Option Period 1: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Total Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Materials/Equipment – The Offeror shall differentiate materials/equipment proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and materials/equipment proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Travel (1) Travel Expenditures Option Period 1 Contract #: TBD All items must have been on proposal or approved in a change request.

Travel requires pre approval documentation.

All items over $5,000 require a receipt.

PWS Paragraph CLIN Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel (See Note 1) Destination Duration Purpose Number of Travelers Proposed Airfare Transportation Cost, if applicable Proposed Rental Car Transportation Cost, if applicable Per Diem Subtotal Indirect Rate Identifier (See Note 2) Total Cost

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel – The Offeror shall differentiate travel proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and travel proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS, if applicable. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Direct Labor (2) Labor Data for Option Period 2: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1) Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2) PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3) Direct Labor Rate Direct Labor Annual Salary Percentage of Effort / Full-Time Equivalent Productive Hours Direct Charged Non-Productive Hours, if applicable Total Direct Salary for Period (Direct Labor Cost) Subtotal Indirect Rate Identifier/Percentage, e.g Fringe, Overhead, etc. (See Note 4) Labor Adders (See Notes 5) Fixed Fee Total Cost / Grand Total Price Comments

TOTAL (as applicable)

NOTES:

Note 1: Exempt / Non-Exempt Labor – The Offeror shall identify whether a proposed labor category is exempt or non-exempt to the Service Contract Act. The Offeror shall either input “Exempt” or “Non-Exempt,” as applicable.

Note 2: Applicable Service Contract Act (SCA) Wage Determination (WD) Number – The Offeror shall identify the applicable SCA WD number, e.g. WD # 2017-0087, as applicable. Offerors are responsible for determining which SCA WD is applicable to its proposed labor.

Note 3: Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor – The Offeror shall differentiate labor proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and labor proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 4: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Note 5: Labor Adders - If proposed compensation includes more than just basic labor pay (i.e., proposed compensation includes additional items such as bonuses, Service Contract Act requirements, etc.). Depending on the offeror's circumstances and proposal preparation methodology, more than one Labor Adder column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Subcontract Labor (2) Subcontract Labor Data for Option Period 2: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1 from "Direct Labor Tab") Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2 from "Direct Labor Tab") PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab") Full Burdened Labor Rate Fully Burdened Annual Salary Percentage of Effort / Full-Time Equivalents Productive Hours Total for Period Rate Identifiers / Labor Adders, if applicable (See Note 4 from "Direct Labor" tab) Fixed Fee, if applicable Total cost / Total Price Comments

TOTAL (as applicable)

Activity Report (2)

Activity Codes Aligning to Labor Category for Direct and SubContract Labor CCE: Date for Option Period 2: XXXX (xx/xx/xx - xx/xx/xx) Note: Labor Category shall match the total reported for Subcontractor and Direct Labor for each category.
Activity CodesWTC Billing Labor CategoryFTETransition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab")Comments
Total FTE reported0

ODC (2)

Other Direct Costs (ODC) for Option Period 2: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Fixed Fee, if applicableTotal Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment ODCs – The Offeror shall differentiate ODCs proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and ODCs proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Rent - Lease (2) Rent/Lease for Option Period: XXXX (xx/xx/xx - xx/xx/xx)

Provide how Rent/Lease is calculated - Include supporting documentation on original invoice and with each change

Materials_Equipment (2) Materials & Equipment for Option Period 2: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Total Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Materials/Equipment – The Offeror shall differentiate materials/equipment proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and materials/equipment proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Travel (2) Travel Expenditures Option Period 2 Contract #: TBD All items must have been on proposal or approved in a change request.

Travel requires pre approval documentation.

All items over $5,000 require a receipt.

PWS Paragraph CLIN Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel (See Note 1) Destination Duration Purpose Number of Travelers Proposed Airfare Transportation Cost, if applicable Proposed Rental Car Transportation Cost, if applicable Per Diem Subtotal Indirect Rate Identifier (See Note 2) Total Cost

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel – The Offeror shall differentiate travel proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and travel proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS, if applicable. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Direct Labor (3) Labor Data for Option Period 3: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1) Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2) PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3) Direct Labor Rate Direct Labor Annual Salary Percentage of Effort / Full-Time Equivalent Productive Hours Direct Charged Non-Productive Hours, if applicable Total Direct Salary for Period (Direct Labor Cost) Subtotal Indirect Rate Identifier/Percentage, e.g Fringe, Overhead, etc. (See Note 4) Labor Adders (See Notes 5) Fixed Fee Total Cost / Grand Total Price Comments

TOTAL (as applicable)

NOTES:

Note 1: Exempt / Non-Exempt Labor – The Offeror shall identify whether a proposed labor category is exempt or non-exempt to the Service Contract Act. The Offeror shall either input “Exempt” or “Non-Exempt,” as applicable.

Note 2: Applicable Service Contract Act (SCA) Wage Determination (WD) Number – The Offeror shall identify the applicable SCA WD number, e.g. WD # 2017-0087, as applicable. Offerors are responsible for determining which SCA WD is applicable to its proposed labor.

Note 3: Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor – The Offeror shall differentiate labor proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and labor proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 4: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Note 5: Labor Adders - If proposed compensation includes more than just basic labor pay (i.e., proposed compensation includes additional items such as bonuses, Service Contract Act requirements, etc.). Depending on the offeror's circumstances and proposal preparation methodology, more than one Labor Adder column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Subcontract Labor (3) Subcontract Labor Data for Option Period 3: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1 from "Direct Labor Tab") Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2 from "Direct Labor Tab") PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab") Full Burdened Labor Rate Fully Burdened Annual Salary Percentage of Effort / Full-Time Equivalents Productive Hours Total for Period Rate Identifiers / Labor Adders, if applicable (See Note 4 from "Direct Labor" tab) Fixed Fee, if applicable Total cost / Total Price Comments

TOTAL (as applicable)

Activity Report (3)

Activity Codes Aligning to Labor Category for Direct and SubContract Labor CCE: Date for Option Period 3: XXXX (xx/xx/xx - xx/xx/xx) Note: Labor Category shall match the total reported for Subcontractor and DIrect Labor for each category.
Activity CodesWTC Billing Labor CategoryFTETransition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab")Comments
Total FTE reported0

ODC (3)

Other Direct Costs (ODC) for Option Period 3: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Fixed Fee, if applicableTotal Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment ODCs – The Offeror shall differentiate ODCs proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and ODCs proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Rent - Lease (3) Rent/Lease for Option Period: XXXX (xx/xx/xx - xx/xx/xx)

Provide how Rent/Lease is calculated - Include supporting documentation on original invoice and with each change

Materials_Equipment (3) Materials & Equipment for Option Period 3: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Total Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Materials/Equipment – The Offeror shall differentiate materials/equipment proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and materials/equipment proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Travel (3) Travel Expenditures Option Period 3 Contract #: TBD All items must have been on proposal or approved in a change request.

Travel requires pre approval documentation.

All items over $5,000 require a receipt.

PWS Paragraph CLIN Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel (See Note 1) Destination Duration Purpose Number of Travelers Proposed Airfare Transportation Cost, if applicable Proposed Rental Car Transportation Cost, if applicable Per Diem Subtotal Indirect Rate Identifier (See Note 2) Total Cost

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Travel – The Offeror shall differentiate travel proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and travel proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS, if applicable. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Direct Labor (4) Labor Data for Option Period 4: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1) Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2) PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3) Direct Labor Rate Direct Labor Annual Salary Percentage of Effort / Full-Time Equivalent Productive Hours Direct Charged Non-Productive Hours, if applicable Total Direct Salary for Period (Direct Labor Cost) Subtotal Indirect Rate Identifier/Percentage, e.g Fringe, Overhead, etc. (See Note 4) Labor Adders (See Notes 5) Fixed Fee Total Cost / Grand Total Price Comments

TOTAL (as applicable)

NOTES:

Note 1: Exempt / Non-Exempt Labor – The Offeror shall identify whether a proposed labor category is exempt or non-exempt to the Service Contract Act. The Offeror shall either input “Exempt” or “Non-Exempt,” as applicable.

Note 2: Applicable Service Contract Act (SCA) Wage Determination (WD) Number – The Offeror shall identify the applicable SCA WD number, e.g. WD # 2017-0087, as applicable. Offerors are responsible for determining which SCA WD is applicable to its proposed labor.

Note 3: Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor – The Offeror shall differentiate labor proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and labor proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 4: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Note 5: Labor Adders - If proposed compensation includes more than just basic labor pay (i.e., proposed compensation includes additional items such as bonuses, Service Contract Act requirements, etc.). Depending on the offeror's circumstances and proposal preparation methodology, more than one Labor Adder column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Subcontract Labor (4) Subcontract Labor Data for Option Period 4: XXXX (xx/xx/xx - xx/xx/xx)

Facility Employee Name WTC Billing Labor Category Exempt / Non-Exempt Labor (See Note 1 from "Direct Labor Tab") Applicable Service Contract Act Wage Determination Number, if applicable (See Note 2 from "Direct Labor Tab") PWS Paragraph Transition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab") Full Burdened Labor Rate Fully Burdened Annual Salary Percentage of Effort / Full-Time Equivalents Productive Hours Total for Period Rate Identifiers / Labor Adders, if applicable (See Note 4 from "Direct Labor" tab) Fixed Fee, if applicable Total cost / Total Price Comments

TOTAL (as applicable)

Activity Report (4)

Activity Codes Aligning to Labor Category for Direct and SubContract Labor CCE: Date for Option Period 4: XXXX (xx/xx/xx - xx/xx/xx) Note: Labor Category shall match the total reported for Subcontractor and DIrect Labor for each category.
Activity CodesWTC Billing Labor CategoryFTETransition-In -OR- Start of Healthcare Delivery/Sustainment Labor (See Note 3 from "Direct Labor Tab")Comments
Total FTE reported0

ODC (4)

Other Direct Costs (ODC) for Option Period 4: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Fixed Fee, if applicableTotal Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment ODCs – The Offeror shall differentiate ODCs proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and ODCs proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Materials_Equipment (4) Materials & Equipment for Option Period 4: XXXX (xx/xx/xx - xx/xx/xx) Contract #: TBD

All items must have been on proposal or approved in a change request. All receipts to be attached
Invoice/Receipt #Category of expensesQuantityAmountDescriptionTransition-In -OR- Start of Healthcare Delivery/Sustainment ODC (See Note 1)Indirect Rate Identifiers, if applicable (See Note 2)Total Cost / Total Price
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Total Other Direct Costs$ - 0

Note 1: Transition-In -OR- Start of Healthcare Delivery/Sustainment Materials/Equipment – The Offeror shall differentiate materials/equipment proposed to meet its proposed technical approach for the transition-in requirements of the Performance Work Statement (PWS) and materials/equipment proposed to meet its proposed technical approach for the Start of HealthCare Delivery (SHCD)/Sustainment requirements of the PWS. The Offeror shall identify this differentiation by inputting “Transition-In” or “SHCD/Sustainment,” as applicable.

Note 2: Indirect Rate Identifier/Percentage, e.g. Fringe, Overhead, etc. - If the costs for a given column in any one period of performance are based on two or more rates, the offeror should provide an appropriately titled column that identifies the rate being used in the calculations for each row. Depending on the offeror's circumstances and proposal preparation methodology, more than one rate identifier column may be needed. The Offeror may add columns as necessary and change the title of the columns as necessary. The Offeror may re-order the columns for the “Rate Identifier/Percentage, e.g. Fringe, Overhead, etc.” and “Labor Adders” requests, as appropriate, to align with the offeror’s circumstances and proposal preparation methodology.

Rent - Lease (4) Rent/Lease for Option Period: XXXX (xx/xx/xx - xx/xx/xx)

Provide…

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