1_AttachmentJ-8a9thSOWPatientPathwaysSpreadsheet.xls

XLS spreadsheet 3 MB Posted Jan 22, 2008

Attached to: 9th SOW Quality Improvement Contracts Federal contract opportunity
Solicitation number: CMS-2007-QIO9thSOW-NAHC
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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Attachment J-8a Patient Pathways

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Other files attached to 9th SOW Quality Improvement Contracts, newest first.
File	Type	Posted
QIONetContinued.zip	ZIP file	Apr 3, 2008
Amendment4aComp.doc	DOC document	Apr 3, 2008
AmendedRFPSectionLandMComp.doc	DOC document	Apr 3, 2008
SDPSMemos.zip	ZIP file	Apr 3, 2008
J11GFP565 State of NY.xls	XLS spreadsheet	Apr 3, 2008
J11GFP565 State of OK.pdf	PDF	Apr 3, 2008
Attach J-21 ModelCDACSubcontract.doc	DOC document	Apr 3, 2008
AmendedRFPSection J .doc	DOC document	Apr 3, 2008
J11GFP565 State of CA.pdf	PDF	Apr 3, 2008
AmendedRFPSection F.doc	DOC document	Apr 3, 2008
AmendedRFPSectionsBthruE.doc	DOC document	Apr 3, 2008
AmendedQsAsFinal.doc	DOC document	Apr 3, 2008
SummaryofChangesCompInstateRFPs.doc	DOC document	Apr 3, 2008
TOPSMemo2006 02.pdf	PDF	Apr 3, 2008
J11GFP565 State of SC.xls	XLS spreadsheet	Apr 3, 2008
AmendedRFPSection H .doc	DOC document	Apr 3, 2008
J11GFP565 State of NV.pdf	PDF	Apr 3, 2008
Amendment2Comp.doc	DOC document	Feb 28, 2008
1_AttachmentJ-17NVPrUlcerandPhysRestraint.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17OKPrUlcerandPhysRestraint.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17SCSCIPHospital.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17NCSCIPHospital.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17NYSCIPHospital.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17MSPrUlcerandPhysRestraint.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17SCPrUlcerandPhysRestraint.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17OKSCIPHospital.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17MSSCIPHospital.pdf	PDF	Feb 5, 2008
1_AttachmentJ-17NYPrUlcerandPhysRestraint.pdf	PDF	Feb 5, 2008
CorrectedRFPCoverLtr.doc	DOC document	Jan 24, 2008
2_SectionIFinal.doc	DOC document	Jan 22, 2008
1_AttachmentJ-6.doc	DOC document	Jan 22, 2008
1_AttachmentJ-13.pdf	PDF	Jan 22, 2008
1_AttachmentJ-1.doc	DOC document	Jan 22, 2008
1_AttachmentJ-4(corrected).doc	DOC document	Jan 22, 2008
1_AttachmentJ-8a9thSOWCKDSpreadsheet.xls	XLS spreadsheet	Jan 22, 2008
1_AttachmentJ-5.doc	DOC document	Jan 22, 2008
2_SectionGFinal.doc	DOC document	Jan 22, 2008
1_AttachmentJ-8BusinessProposal9thSOWFormatInstructions.rtf	RTF text file	Jan 22, 2008
2_SectionLandMFinalCompetitive1.doc	DOC document	Jan 22, 2008
1_AttachmentJ-8aBP9SOW.xls	XLS spreadsheet	Jan 22, 2008
1_AttachmentJ-6a.doc	DOC document	Jan 22, 2008
2_SectionJFinal.doc	DOC document	Jan 22, 2008
1_AttachmentJ-11.pdf	PDF	Jan 22, 2008
2_SectionFFinal.doc	DOC document	Jan 22, 2008
2_SectionKFinal.doc	DOC document	Jan 22, 2008
1_AttachmentJ-10.doc	DOC document	Jan 22, 2008
1_AttachmentJ-7.doc	DOC document	Jan 22, 2008
1_AttachmentJ-15.doc	DOC document	Jan 22, 2008
2_SF33.doc	DOC document	Jan 22, 2008
1_AttachmentJ-3.pdf	PDF	Jan 22, 2008

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F718 BP SUM

1. Name and Address of QIO Organization						3. RFP #
						4: Proposed Contract Period
2. QIO Area (State):						From:
						To:
	Medicare		5. Total Proposed		6. CMS Recommended		7. $	8. %
	Contract		Costs		Costs		Difference	DIfference
Direct Cost
a. LABOR:
1. Professional			$0		$0		$0	0.0%
2. Information Systems			$0		$0		$0	0.0%
3. Corporate Management			$0		$0		$0	0.0%
4. Support Staff			$0		$0		$0	0.0%
SUBTOTAL - Direct Labor			$0		$0		$0	0.0%
b. Leave			$0		$0		$0	0.0%
c. Fringe Benefits			$0		$0		$0	0.0%
SUBTOTAL - Leave/Fringe			$0		$0		$0	0.0%
d. Subcontractors
1. Physician Reviewers/ Phys.Advisors
2. Other Consultants			$0		$0		$0	0.0%
3. Other Subcontracts			$0		$0		$0	0.0%
SUBTOTAL - Subcontractors			$0		$0		$0	0.0%
e. Travel			$0		$0		$0	0.0%
f. Other Direct Costs			$0		$0		$0	0.0%
SUBTOTAL - DIRECT			$0		$0		$0	0.0%
g. Indirect Costs			$0		$0		$0	0.0%
h. Pass-thru Costs			$0		$0		$0	0.0%
TOTAL COSTS			$0		$0		$0	0.0%
i. Fee			$0		$0		$0	0.0%
TOTAL COST WITH FEE			$0		$0		$0	0.0%
9.
		10. Signature of Authorized Official:					CMS USE ONLY
Fringe Rate
						14. Proposal Receipt Date:
Indirect Rate		11. Type or Print Name and Title:
Other Rate						15. Review By:
		12. DATE:		13. Telephone #
						16. Signature/Title:

&C&"Arial,Bold"QUALITY IMPROVEMENT ORGANIZATION 9th SOW BUSINESS PROPOSAL SUMMARY FOR PATIENT PATHWAYS &"Arial,Regular"CENTERS FOR MEDICARE and MEDICAID SERVICES &LForm 718 BP&R&9Prepared on:

QIO F719

1. RFP Number:	2. Name and Address of QIO Organization:				3. QIO Area (State):		4. Contract Period
0	0						From:	12/31/99
	0					0	To:	12/31/99
	0
	5. Community Provider/ Recruitment Selection		6. Interventions		7. Monitoring/Reports		8. Evaluation		9. Total
MEDICARE COSTS									20. TOTAL
	Theme: Patient Pathways		Theme: Patient Pathways		Theme: Patient Pathways		Theme: Patient Pathways
	HOURS	COSTS	HOURS	COSTS	HOURS	COSTS	HOURS	COSTS	HOURS	COSTS
a. LABOR:
1. Professional	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
2. Information Systems	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
3. Corporate Management	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
4. Support Staff	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
SUBTOTAL - Direct Labor	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
b. Leave	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
c. Fringe Benefits		$0		$0		$0		$0		$ - 0
SUBTOTAL - Leave / Fringe	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
d. Subcontracts:
1. Physician Reviewers / Phys. Advisors
2. Other Consultants		$0		$0		$0		$0		$ - 0
3. Other Subcontractors		$0		$0		$0		$0		$ - 0
SUBTOTAL - Subcontracts	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$ - 0
e. Travel		$0		$0		$0		$0		$ - 0
f. Other Direct Costs		$0		$0		$0		$0		$ - 0
SUBTOTAL - DIRECT	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0
g. Indirect Costs		$0		$0		$0		$0		$ - 0
h. Pass-thru Costs		$0		$0		$0		$0		$ - 0
TOTAL COSTS	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0
i. Fee		$0		$0		$0		$0		$ - 0
TOTAL COSTS WITH FEE		$0		$0		$0		$0		$ - 0

&C&11Quality Improvement Organization 9th SOW - Patient Pathways Business Proposal&10 Centers for Medicare and Medicaid Services &L&11Form 719 BP&CPage &P&RPrepared on:

QIO F720

				FRINGE BENEFIT PROPOSAL
			QUALITY IMPROVEMENT ORGANIZATION 9th SOW - PATIENT PATHWAYS BUSINESS PROPOSAL
			CENTERS FOR MEDICARE & MEDICAID SERVICES
1. Name and Address of QIO Organization							3. RFP #
0							0
0
0							4: Proposed Contract Period
2. QIO Area (State):		0					From:	12/31/99
							To:	12/31/99
				6. Prior Year		7. Projected			8. Prior Year	9. Projected
	DETAIL COSTS			Total		Total 3-YR			Total	Total 3-YR
			Organization Costs		Organization Costs				Medicare Costs	Medicare Costs
Fringe Benefits
a. Employer's FICA Expense						$0				$0
b. Federal Unemployment Insurance						$0				$0
c. State Unemployment Insurance						$0				$0
d. Disability Insurance						$0				$0
e. Pension Expense						$0				$0
f. Workers Compensation						$0				$0
g. Group Health Insurance						$0				$0
h. Group Life Insurance						$0				$0
i. Empl. Relations & Welfare						$0				$0
j. Leave						$0				$0
k. Other - see attached						$0				$0
l. Total Fringe Benefits						$0				$0
m. Fringe Benefit Rate				0.00%		0.00%			0.00%	0.00%

&LForm 720 BP&R&D

QIO F721

		INDIRECT AND OTHER DIRECT COST
		QUALITY IMPROVEMENT ORGANIZATION 9th SOW - PATIENT PATHWAYS BUSINESS PROPOSAL
		CENTERS FOR MEDICARE & MEDICAID SERVICES
1. Name and Address of QIO Organization					3. RFP #
0					0
0
0					4: Proposed Contract Period
2. QIO Area (State):		0			From:	12/31/99
					To:	12/31/99
			5. Prior Year	6. Projected	7. Prior Year	8. Projected	9. Prior Year	10. Projected
	DETAIL COSTS		Total	Total 3yr.	Medicare	Medicare 3yr	Medicare	Medicare 3yr
			Indirect Costs	Indirect Costs	Indirect Costs	Indirect Costs	Other Direct.	Other Direct.
a. Indirect Labor				$0		$0
b. Indirect Leave				$0		$0
c. Indirect Fringe				$0		$0
d. Rent				$0		$0	$0	$0
e. Storage				$0		$0	$0	$0
f. Utilities				$0		$0	$0	$0
g. Maintenance & Repairs				$0		$0	$0	$0
h. Depreciation				$0		$0	$0	$0
i. Data Processing				$0		$0	$0	$0
j. Equipment Leasing & Rental				$0		$0	$0	$0
k. Office Supplies				$0		$0	$0	$0
l. Reproduction & Printing				$0		$0	$0	$0
m. Telephone				$0		$0	$0	$0
n. Postage & Express Mail				$0		$0	$0	$0
o. Consultants				$0		$0
p. Meeting & Conferences				$0		$0	$0	$0
q. Travel				$0		$0
r. Training				$0		$0	$0	$0
s. Garage & Parking Spaces				$0		$0	$0	$0
t. Dues & Subscriptions				$0		$0	$0	$0
u. Recruiting				$0		$0	$0	$0
v. Temporary Help				$0		$0	$0	$0
w. Continuing Education				$0		$0	$0	$0
x. Legal Fees				$0		$0	$0	$0
y. Accounting/Audit Fees				$0		$0	$0	$0
z. Board of Directors Fees				$0		$0	$0	$0
aa. Insurance				$0		$0	$0	$0
bb. Bank Charges				$0		$0	$0	$0
cc. Other - see attached				$0		$0	$0	$0
dd. ** TOTAL				$0		$0	$0	$0
ee. Indirect Cost Rate			0.00%	0.00%

&LForm 721 BP &R&D

QIO STAFFING

																											11. Average	Community Provider/Recruitment Selection	Community Provider/Recruitment Selection	Community Provider/Recruitment Selection	Community Provider/Recruitment Selection	12. Total 3yr	Community Provider/Recruitment Selection	Community Provider/Recruitment Selection	Community Provider/Recruitment Selection		13. Average	Interventions	Interventions	Interventions	Interventions	14. Total 3yr	Interventions	Interventions	Interventions	Interventions	15. Average	Monitoring/Reports	Monitoring/Reports
					4a current	4b current	4c current	4d current	5. Proposed	5a ProposedYr 1	5b PropYr1	5c Prop Yr 1	5d Prop Yr 1		7. Proposed	7aProposedYr	7bPropYr2	7c Prop Yr 2	7d Prop Yr 2		9. Proposed	9aProposedYr 3	9bPropYr3	9c Prop Yr 3	9d Prop Yr 3		Community Provider/Recruitment Selection					Community Provider/Recruitment Selection				Community Provider/Recruitment Selection	Interventions					Interventions	Prof. Labor	IS labor	Corp Admin	Support	Monitoring/Reports
	1. Staff	2. Position	3. Labor	4. Current	hourly	hourly	hourly	hourly	Year 1	hourly	hourly	hourly	hourly	6. Percent	Year 2	hourly	hourly	hourly	hourly	8. Percent	Year 3	hourly	hourly	hourly	hourly	10. Percent		per year	per year	hours per yr	Staff Hrs per		costs/yr	$$ per year	Labor $ per yr			per year	per year	hours per yr	Staff Hrs per		costs/yr	$$ per year	Labor $ per yr	Staff Hrs per		per year	per year
	Name	Title	Category Code	Hourly Rate	professional	IS	Corp Admin	support staff	Hourly Rate	professional	IS	Corp Admin	support staff	Change	Hourly Rate	professional	IS	Corp Admin	support staff	Change	Hourly Rate	professional	IS	Corp Admin	support staff	Change	Hours Per Year	avg	avg	avg	yr, avg	Labor Costs	avg	avg	avg	Labor $$yr, avg	Hours Per Year	avg	avg	avg	yr, avg	Labor Costs	avg	avg	avg	Labor $$yr, avg	Hours Per Year	avg	avg
1					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
2					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
3					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
4					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
5					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
6					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
7					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
8					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
9					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
10					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
11					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
12					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
13					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
14					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
15					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
16					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
17					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
18					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
19					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
20					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
21					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
22					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
23					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
24					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
25					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
26					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
27					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
28					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
29					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
30					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
31					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
32					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
33					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
34					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
35					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
36					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
37					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
38					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
39					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
40					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
41					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
42					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
43					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
44					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
45					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
46					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
47					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
48					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
49					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
50					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
51					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
52					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
53					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
54					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
55					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
56					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
57					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
58					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
59					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
60					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
61					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
62					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
63					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
64					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
65					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
66					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
67					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
68					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
69					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
70					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
71					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
72					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
73					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
74					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
75					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
76					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
77					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
78					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
79					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
80					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
81					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
82					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
83					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
84					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
85					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
86					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
87					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
88					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
89					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
90					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
91					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
92					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
93					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
94					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
95					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
96					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
97					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
98					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
99					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
100					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
101					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
102					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
103					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
104					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
105					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
106					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
107					$0.00	$0.00	$0.00	$0.00		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		$0.00	$0.00	$0.00	$0.00	0.0%		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0	0	0	$0	$ - 0	$ - 0	$ - 0	$ - 0		0	0
Grand Total	N/A	N/A	N/A	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	0.0%	$0.00	$0.00	$0.00	$0.00	$0.00	0.0%	$0.00	0	0	0	0	0.0%	0.0	0	0	0	0	$0	$ -	$ -	$ -	$ -	0.0	0	0	0	0	$0	$ -	$ -	$ -	$ -	0.0	0	0
By Category
P=Professional				$0.00					$0.00					0.0%	$0.00					0.0%	$0.00					0.0%	0.0					$ - 0					0.0					$ - 0					0.0
I=Info Systems				$0.00					$0.00					0.0%	$0.00					0.0%	$0.00					0.0%	0.0					$ - 0					0.0					$ - 0					0.0
C=Corp Mgmt				$0.00					$0.00					0.0%	$0.00					0.0%	$0.00					0.0%	0.0					$ - 0					0.0					$ - 0					0.0
S=Support Staff				$0.00					$0.00					0.0%	$0.00					0.0%	$0.00					0.0%	0.0					$ - 0					0.0					$ - 0					0.0
Check Cell for Columns: Sum of 114 through 117 should equal value in 112																											0.0					$ - 0					0.0					$ - 0					0.0
				Averaging
				Counts	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0

&CStaffing Proposal Personnel Loading Chart Quality Improvement Organization 9th SOW - Patient Pathways Business Proposal &LForm Staffing&CPage &P&R&D

QIOSubconts 2

		2. Community Provider/Recruitment Selection	3. Interventions	4. Monitoring/Reports	5. Evaluation	BLANK	6.
	1.						Total	7.	8.
	Name						3 YR Costs	Current Activity	Proposed Activity
1	Other Consultants:
a							$0
b							$0
c							$0
d							$0
e							$0
f							$0
g							$0
h							$0
i							$0
j							$0
k	(See Attached)						$0
	Subtotal - Other Consultants	$0	$0	$0	$0	$0	$0
2	Other Subcontractors:
a							$0
b							$0
c							$0
d							$0
e							$0
f							$0
g							$0
h							$0
i							$0
j							$0
k	(See Attached)						$0
	Subtotal - Other Subcontractors	$0	$0	$0	$0	$0	$0

&C&11Subcontracts Proposal Quality Improvement Organization 9th SOW - Patient Pathways Business Proposal &"Arial,Bold"Other Consultants and Other Subcontractors &LForm SC 2 &CPage &P&RPrepared on:

QIO Staff Sum

Labor Category	1. Average	2. Proposed		4. Proposed		6. Proposed		8. Total Community Provider/Recruitment Selection Hours	9. Total Community Provider/Recruitment Selection Labor Costs	10. Total Interventions Hours	11. Total Interventions Labor Costs	12. Total Monitoring/Reports Hours	13. Total Monitoring/Reports Labor Costs	14. Total Evaluation Hours	15. Total Evaluation Labor Costs	16. BLANK	17. BLANK	18. Total	19. Total	20. Total	21. Total	22. Total	23. Total	24. Total	25. Total	26. Total	27. Total	28. Total	29. Leave as a	30. Total	31. Total	32. Total
	Current	Average Year 1	3. Percent	Average Year 2	5. Percent	Average Year 3	7. Percent											Direct Labor	Direct Labor	Indirect Labor	Indirect Labor	Labor	Labor	Direct Leave	Direct Leave	Indirect Leave	Indirect Leave	Leave	% of Hours	Leave	Labor and Leave	Labor and Leave	33. Total FTE
	Hourly Rate	Hourly Rate	Change	Hourly Rate	Change	Hourly Rate	Change											Hours	Costs	Hours	Costs	Hours	Costs	Hours	Costs	Hours	Costs	Hours	Worked	Costs	Hours	Costs	Per Year
Professional	$ - 0	$ - 0	0.0%	$ - 0	0.0%	$ - 0	0.0%	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	0.0%	$0	0.0	$0	0.00
Information Systems	$ - 0	$ - 0	0.0%	$ - 0	0.0%	$ - 0	0.0%	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	0.0%	$0	0.0	$0	0.00
Corporate Management	$ - 0	$ - 0	0.0%	$ - 0	0.0%	$ - 0	0.0%	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	0.0%	$0	0.0	$0	0.00
Support Staff	$ - 0	$ - 0	0.0%	$ - 0	0.0%	$ - 0	0.0%	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	0.0%	$0	0.0	$0	0.00
Total	$ - 0	$ - 0	0.0%	$ - 0	0.0%	$ - 0	0.0%	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	$0	0.0	0.0%	$0	0.0	$0	0.00

&CStaffing Proposal Summary Quality Improvement Organization 9th SOW - Patient Pathways Business Proposal &LForm Sum&CPage &P&RPrepared on:

QIO ODC

			OTHER DIRECT COST FOR PATIENT PATHWAYS
			QUALITY IMPROVEMENT ORGANIZATION 9th SOW BUSINESS PROPOSAL
			CENTERS FOR MEDICARE & MEDICAID SERVICES
1. Name and Address of QIO Organization				3. RFP #
0				0
0
0				4: Proposed Contract Period
2. QIO Area (State):	0			From:	12/31/99
				To:	12/31/99
DETAIL COSTS		5. Community Provider/Recruitment Selection	6. Interventions	7. Monitoring/Reports	8. Evaluation	Total Projected Medicare - 3yr Other Direct Costs
d. Rent		$0	$0	$0	$0	$0
e. Storage		$0	$0	$0	$0	$0
f. Utilities		$0	$0	$0	$0	$0
g. Maintenance & Repairs		$0	$0	$0	$0	$0
h. Depreciation		$0	$0	$0	$0	$0
i. Data Processing		$0	$0	$0	$0	$0
j. Equipment Leasing & Rental		$0	$0	$0	$0	$0
k. Office Supplies		$0	$0	$0	$0	$0
l. Reproduction & Printing		$0	$0	$0	$0	$0
m. Telephone		$0	$0	$0	$0	$0
n. Postage & Express Mail		$0	$0	$0	$0	$0
o. Consultants
p. Meeting & Conferences		$0	$0	$0	$0	$0
q. Travel
r. Training		$0	$0	$0	$0	$0
s. Garage & Parking Spaces		$0	$0	$0	$0	$0
t. Dues & Subscriptions		$0	$0	$0	$0	$0
u. Recruiting		$0	$0	$0	$0	$0
v. Temporary Help		$0	$0	$0	$0	$0
w. Continuing Education		$0	$0	$0	$0	$0
x. Legal Fees		$0	$0	$0	$0	$0
y. Accounting/Audit Fees		$0	$0	$0	$0	$0
z. Board of Directors Fees		$0	$0	$0	$0	$0
aa. Insurance		$0	$0	$0	$0	$0
bb. Bank Charges		$0	$0	$0	$0	$0
cc. Other - see attached		$0	$0	$0	$0	$0
TOTAL		$0	$0	$0	$0	$0

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File details come from the government source that posted it. Updated Nov 14, 2017.