Budget Template Spreadsheet.xlsx

XLSX spreadsheet 112 KB Posted

Attached to
2 PAM Autoinjectors Federal contract opportunity
Solicitation number
75A50122R00022
Issued by
Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response

About this file

This document includes a request for proposals from the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response for the development and procurement of 2-PAM autoinjectors to treat organophosphate poisoning. The RFP seeks proposals for late-stage clinical development and regulatory approval of 2-PAM autoinjectors as a drug-device combination product for adult and pediatric populations. It also seeks procurement of 2-PAM autoinjectors for the Strategic National Stockpile/CHEMPACK Program. Questions regarding the RFP are due by July 21, 2022, and proposals must be submitted by August 15, 2022. The attached budget template spreadsheet should be used to develop cost proposals. The SF33 form and RFP document are also attached.

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Other files for this federal contract opportunity

Other files attached to 2 PAM Autoinjectors, newest first.
File Type Posted
Questions and Answers 2PAM AI (Parts 1-4).pdf PDF
Questions and Answers Pts1-3 2PAM AI.pdf PDF
Questions and Answers Pts1and2 2PAM.pdf PDF
Questions and Answers Pt1 2PAM.pdf PDF
RFP for 2PAM AutoInjectors.pdf PDF
75A50122R00022 SF33.pdf PDF

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INSTRUCTIONS

How to Use this Excel file:

Important: Please save this file on your computer before attempting to insert data.

This worksheet is intended to help you prepare your cost proposal. If you provide us with an electronic copy of the cost proposal, we can save time by not recreating it. This will help speed up the review/award process and perhaps reduce the number of questions we would need to ask in order to understand your proposal. We understand that one spreadsheet format cannot fit every situation; however, we have attempted to provide you with a model that fits most circumstances that arise in government contracting. Feel free to modify the spreadsheet to fit your circumstances and to use the parts that work for you.

Summary Page

Please insert your organization's name in cell A2 and the RFP No. in cell A3.

The totals from each cost element page are automatically carried forward to the Summary worksheet. Enter the start date of the contract in cell C5.

This Excel file is set up for seven periods with each period on an annual basis; however, make the dates consistent with the respective work segment (i.e., Contract Line Item Numbers) periods (i.e., 2 years, 3 years, etc.) of your project.

Direct Labor

Use the Labor - Percent of Effort worksheet if you track labor on a percent of effort basis. Generally, Universities, Hospitals, and Non-Profit Organizations track labor by percent of effort.

Use the Labor - Hourly worksheet if you track labor on an hourly basis. Commercial organizations track labor on an hourly basis.

Use both pages if you track some employees by each method. Please do not put any employee on both pages.

The proposed amounts must be based on current payroll information that shows hourly, monthly, or annual rate/salary for each proposed (named) individuals. Acceptable documentation includes any one of the following: 1) personnel action forms, or 2) most recent payroll register showing name, pay rate, and percent of effort, if applicable, or 3) copy of pay stub. Supporting documentation may be requested later.

If the proposed positions have not been named, or are to be filled or pending employees to be hired, then acceptable documentation includes the following: 1) letter of intent to hire, including salary rate and title, or 2) position descriptions and salary scales or organizational wage table showing salary range and a copy of hiring policy, or 3) a comparable employee's payroll document. Supporting documentation may be requested later. Annual increase for proposed positions that are to be named, or are named, but are to be filled, are not eligible for increases in the first period.

Indirect Rates Including Fringe Benefit Rate(s) for Commercial Organizations

If your organization does not have negotiated rates, the following URL contains information that will assist you in computing indirect rates: https://oamp.od.nih.gov/dfas/indirect-cost-branch/indirect-cost-submission. Please do not submit your indirect cost proposal to the Division of Financial Advisory Services at this time.

Point of Contact

If you have any questions, please contact the Contracting Officer.

SUMMARY

SUMMARY OF PROPOSED COSTS
** Contractor's Name
** RFP/BAA No.CLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
PERIOD IPERIOD IIPERIOD IIIPERIOD IVPERIOD VPERIOD VIPERIOD VIITOTAL
*** Period ( dates)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)
ThroughThroughThroughThroughThroughThroughThrough
(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)(mm/dd/yy)
Direct Labor - Percent of Effort$0$0$0$0$0$0$0$0
Fringe Benefits - Percent of Effort00000000
Direct Labor - Hourly00000000
Fringe Benefits - Hourly00000000
Total Direct Labor & Fringe Benefits$0$0$0$0$0$0$0$0

* Overhead 0% $0 0% $0 0% $0 0% $0 0% $0 0% $0 0% $0 $0

Materials and Supplies$0$0$0$0$0$0$0$0
Professional Travel00000000
Equipment00000000
Consultants00000000
Other Direct Costs00000000
Patient Care Costs00000000
Subcontracts00000000
Total Other Direct Costs$0$0$0$0$0$0$0$0
Subtotal: Direct Labor, Fringe Benefits, Overhead, & Other Directs$0$0$0$0$0$0$0$0
*Exclusion(s) from Base for G&A00000000
*Adjusted Base for G&A$0$0$0$0$0$0$0$0
*G&A0%00%00%00%00%00%00%00
Total Proposed Cost Excluding Fee00000000
Proposed Fee/Profit0%00%00%00%00%00%00%00
Total Proposed Cost Plus Fee/Profit$0$0$0$0$0$0$0$0
**
***

Not all organizations allocate indirect costs the same way. It is important that you use the indirect rate structure applicable to your organization. For example, if you have a three tier indirect rate structure, then you will use a three tier structure when proposing indirect costs.

Generally, universities and non-profits have fringe benefit and G&A (sometimes called F&A) rates, while for-profit companies can have various indirect rates such as fringe benefits, overhead, G&A, etc.

The base for overhead costs includes direct labor and fringe benefits. Please modify if your base is different.

If applicable, insert exclusions to the G&A base in row 26.

Please insert the Company's name and the RFP No.

Enter the contract start date in cell C5 and make adjustments for leap year.

LABOR - Percent of Effort

SUMMARY OF DIRECT LABOR
AND FRINGE BENEFITS
PERCENT OF EFFORTCLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
** Contractor's NamePERIOD I*PERIOD II*PERIOD III*PERIOD IV*PERIOD V*PERIOD VI*PERIOD VII*
** RFP/BAA No.(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)TOTALTOTAL
CURRENTADJUSTEDPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGEPERCENT OFNUMBERSALARYFRINGEFRINGESALARYFRINGE
EMPLOYEEPOSITIONBASE SALARYBASE SALARYEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTCOSTCOST
1$0$00%12.00$00%$00%12.00$00%$00%12.00$00%$00%12.00$00%$00%12.00$00%$00%12.00$00%$00%12.00$00%$0$0$0
2000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
3000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
4000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
5000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
6000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
7000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
8000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
9000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
10000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
11000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
12000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
13000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
14000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
15000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
16000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
17000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
18000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
19000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
20000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
21000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
22000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
23000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
24000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
25000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
26000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
27000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
28000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
29000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
30000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
31000%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%00%12.0000%000
SUBTOTALS =0%$0$00%$0$00%$0$00%$0$00%$0$00%$0$00%$0$0$0$0

ANNUAL INCREASE FACTOR: 0.00%

ANNUAL INCREASE DATE: 00/00/00

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE 0

*Adjust the number of months per period as recommended in the RFP/BAA.

The following boxes in Column "D" below may be used to calculate the ADJUSTED BASE SALARY as indicated:

(Use of these cells will affect the entire adjusted base salary column; if individual anniversary dates differ, the adjusted base salaries must be entered individually in Column "D" of the spreadsheet and explained in the budget justification) Insert annual CPI % and/or merit increases and explain the % in the budget justification.

Insert annual increase date.

Insert number of months using the new salary.

LABOR - Hourly

SUMMARY OF DIRECT LABOR
AND FRINGE BENEFITS
Hourly RatesCLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
** Contractor's NamePERIOD I*PERIOD II*PERIOD III*PERIOD IV*PERIOD V*PERIOD VI*PERIOD VII*
** RFP/BAA No.(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)(mm/dd/yy)Through(mm/dd/yy)TOTALTOTAL
CURRENT BASEADJUSTEDNUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGENUMBERNUMBERSALARYFRINGEFRINGESALARYFRINGE
EMPLOYEEPOSITIONHOURLY RATEHOURLY RATEHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTHOURSMONTHSCOSTRATECOSTCOSTCOST
1$0.00$0.000.0012.00$00%$00.0012.00$00%$00.0012.00$00%$00.0012.00$00%$00.0012.00$00%$00.0012.00$00%$00.0012.00$00%$0$0$0
20.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
30.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
40.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
50.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
60.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
70.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
80.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
90.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
100.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
110.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
120.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
130.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
140.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
150.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
160.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
170.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
180.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
190.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
200.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
210.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
220.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
230.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
240.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
250.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
260.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
270.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
280.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
290.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
300.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
310.000.000.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%00.0012.0000%000
SUBTOTALS =0.00$0$00.00$0$00.00$0$00.00$0$00.00$0$00.00$0$00.00$0$0$0$0
NUMBER OF HOURS FOR FULL TIME EQUIVALENT:0
ANNUAL INCREASE FACTOR:0.00%

ANNUAL INCREASE DATE: 00/00/00

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE 0

*Adjust the number of months per period as recommended in the RFP/BAA

The following boxes in Column "D" below may be used to calculate the ADJUSTED BASE SALARY as indicated:

(Use of these cells will affect the entire adjusted base salary column; if individual anniversary dates differ, the adjusted base salaries must be entered individually in Column "D" of the spreadsheet and explained in the budget justification) Insert annual increase date.

Insert annual CPI % and/or merit increases and explain the % in the budget justification.

Insert number of months using the new salary.

Insert your direct work year.

Materials

SUMMARY OF MATERIALS AND SUPPLIES
** Contractor's Name
** RFP/BAA No.
CLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
Period IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VII
UnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
30.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
40.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
50.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
60.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
70.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
80.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
90.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
100.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
110.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
120.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
130.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
140.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
150.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
160.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
170.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
180.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
190.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
200.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
210.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
220.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
230.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
240.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
250.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
260.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
270.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
280.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
290.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
300.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
TOTAL =$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00

&24&USUMMARY OF MATERIALS AND SUPPLIES

Please use current catalog, historical documentation, or vendor quotes. Supporting documentation may be requested later.

Travel

SUMMARY OF TRAVEL COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
Cost ElementPeriod IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VIITOTAL
Trip #1111111
Site
Reason
Airfare$0$0$0$0$0$0$0
Lodging0000000
Meals0000000
Incidentals0000000
Ground Transport0000000
Total Per Trip$0$0$0$0$0$0$0
No. of persons0000000
SUBTOTAL =$0$0$0$0$0$0$0$0
Trip #2222222
Site
Reason
Airfare$0$0$0$0$0$0$0
Lodging0000000
Meals0000000
Incidentals0000000
Ground Transport0000000
Total Per Trip$0$0$0$0$0$0$0
No. of persons0000000
SUBTOTAL =$0$0$0$0$0$0$0$0
Trip #3333333
Site
Reason
Airfare$0$0$0$0$0$0$0
Lodging0000000
Meals0000000
Incidentals0000000
Ground Transport0000000
Total Per Trip$0$0$0$0$0$0$0
No. of persons0000000
SUBTOTAL =$0$0$0$0$0$0$0$0
TOTAL COST BY PERIOD =$0$0$0$0$0$0$0$0

Please review the RFP/BAA for the recommended number of trips and destinations, if applicable. Please use the company or institutional travel policy unless current government per diem rates are utilized. Please use current vendor quotes for airfare and other travel costs. Supporting documentation may be requested later.

Equipment

SUMMARY OF EQUIPMENT COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
Period IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VII
UnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
30.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
40.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
50.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
60.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
70.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
80.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
90.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
100.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
110.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
120.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
130.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
140.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
150.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
160.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
170.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
180.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
190.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
200.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
210.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
220.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
230.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
240.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
250.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
260.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
270.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
280.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
290.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
300.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
TOTAL =$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00

&24&USUMMARY OF EQUIPMENT COSTS

All proposed equipment costs should include a justification and be based on current vendor quotes. Supporting documentation may be requested later.

Consultants

SUMMARY OF CONSULTANT COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0001CLIN 0002CLIN 0003
Period IPeriod IIPeriod III
CONSULTANTRate# Hours# DaysTravelSubtotalRate# Hours# DaysTravelSubtotalRate# Hours# DaysTravelSubtotal
(1)$0$0$0$0$0$0$0$0$0
(2)000000000
(3)000000000
(4)000000000
(5)000000000
(6)000000000
(7)000000000
(8)000000000
(9)000000000
(10)000000000
TOTAL =$0$0$0
CLIN 0004CLIN 0005
Period IVPeriod V
CONSULTANTRate# Hours# DaysTravelSubtotalRate# Hours# DaysTravelSubtotal
(1)$0$0$0$0$0$0
(2)000000
(3)000000
(4)000000
(5)000000
(6)000000
(7)000000
(8)000000
(9)000000
(10)000000
TOTAL =$0$0
CLIN 0006CLIN 0007
Period VIPeriod VII
CONSULTANTRate# Hours# DaysTravelSubtotalRate# Hours# DaysTravelSubtotalTOTAL
(1)$0$0$0$0$0$0$0
(2)0000000
(3)0000000
(4)0000000
(5)0000000
(6)0000000
(7)0000000
(8)0000000
(9)0000000
(10)0000000
TOTAL =$0$0$0

Please provide a complete breakdown for each consultant with rates for the number of hours or days plus any proposed travel costs (including travel rates). Please obtain a signed letter of commitment which shows the base rate for each consultant. Supporting documentation may be requested later.

Other Direct

SUMMARY OF OTHER DIRECT COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0001CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
Period IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VII
UnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
30.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
40.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
50.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
60.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
70.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
80.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
90.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
100.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
110.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
120.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
130.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
140.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
150.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
160.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
170.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
180.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
190.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
200.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
210.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
220.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
230.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
240.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
250.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
260.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
270.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
280.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
290.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
300.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
TOTAL =$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00

&24&USUMMARY OF OTHER DIRECT COSTS

Please use current catalog prices or vendor quotes. Supporting documentation may be requested later.

Patient Care

SUMMARY OF PATIENT CARE COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0002CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0006CLIN 0007
Period IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VII
UnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
30.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
40.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
50.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
60.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
70.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
80.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
90.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
100.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
110.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
120.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
130.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
140.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
150.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
160.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
170.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
180.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
190.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
200.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
210.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
220.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
230.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
240.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
250.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
260.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
270.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
280.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
290.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
300.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.0000.000.00
TOTAL =$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00

&24&USUMMARY OF PATIENT CARE COSTS

Please use current institutional costs or vendor quotes. Supporting documentation may be requested later.

Subcontracts

SUMMARY OF SUBCONTRACTOR COSTS
** Contractor's Name
** RFP/BAA No.
CLIN 0002CLIN 0003CLIN 0004CLIN 0005CLIN 0005CLIN 0006CLIN 0007
SUBCONTRACT #Period IPeriod IIPeriod IIIPeriod IVPeriod VPeriod VIPeriod VIITOTAL
(1)$0$0$0$0$0$0$0$0
(2)00000000
(3)00000000
(4)00000000
(5)00000000
(6)00000000
(7)00000000
(8)00000000
(9)00000000
(10)00000000
TOTAL =$0$0$0$0$0$0$0$0

A complete breakdown and summary sheet for each proposed subcontract must be included with the offeror's proposal. The same format should be used for both the prime and subcontract proposals.

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