J-16_CLIN_0007_Cost_Proposal_Templates_Close_Out_Period.xlsx
XLSX spreadsheet 25 KB Posted
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- DME MAC Jurisdiction D
- Solicitation number
- CMS-RFP-2010-0016
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Attachment J-16 CLIN 0007 Cost Proposal Templates Implementation ver 2003 and 2007 xlsx
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CLIN-0007
| COST TEMPLATE - SAMPLE Attachment J-16 | |||||||||
| (Provide a cost spreadsheet for each CLIN proposed) | |||||||||
| CLIN 0007 | C.1.2 | I | |||||||
| DME SERVICES | Total FTEs | Contractor Responsibilities during Closeout | AWARD FEE | GRAND TOTAL | |||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Total | ||
| COST ELEMENTS |
| Direct Labor | |||||
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| Add Other Appropriate Labor Categories (note: labor categories should match WBS) | 0 | $0.00 | $0 | 0 | $0.00 |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $0.00 | $0 | 0 | $0.00 | |
| 0 | $1.00 | $0 | 0 | $0.00 | |
| Subtotal Direct Labor | 0 | $0 | 0 | $0.00 |
Fringe Benefits (at ____%) $0 $0.00
Total Direct Labor $0 $0.00
| Travel (see separate schedule) | $0 | $0.00 | ||
| SUBCONTRACTORS | ||||
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Subcontractor Name | 0 | $0 | 0 | $0.00 |
| Total Subcontractor | 0 | $0 | 0 | $0.00 |
Other Direct Costs (See separate schedule) $0 $0.00
SUBTOTAL ALL DIRECT COSTS $0 $0.00
Indirect Costs (at ______ %) $0 $0.00
TOTAL OTHER BEFORE FEES $0 $0.00
| Base Fee (at ____%) | $0 | $0.00 | |
| Award Fee (at ______%) | $0 | $0.00 |
TOTAL OTHER AFTER FEES $0 $0 $0
GRAND TOTAL $0
CMS-RFP-2010-0016
Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC)
Attachment J-16 CLIN 0007 Cost Proposal Template &P
ODC Schedule
| COST TEMPLATE - SAMPLE Attachment J-16 | |
| (Provide an ODC Spreadsheet for each CLIN Proposed) | |
| CLIN 0007 DME SERVICES | |
| Cost Element | TOTAL |
Add costs by category
TOTAL ODCs $0.00
CMS-RFP-2010-0016
Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC)
Attachment J-16 CLIN 0007 Cost Proposal Template &P
Travel
| TRAVEL SUMMARY |
| CLIN 000X |
| Purpose of Trip | SOW WBS | |||
| Crosswalk | Labor Category Taking Trip | Trip Origin | Destination | # People |
| (A) | # Trips | |||
| (B) | # Days | |||
| (C) | # Nights | |||
| (D) | Lodging Rate | |||
| (E) | Lodging | |||
| (F=E*D*A) | M&IE | |||
| (G) | Total Lodging |
and M&IE
| (H=F+G) | Airfare |
| (I) | Car Rental |
| (J) | Misc |
| (K) | Local |
Mileage
| (L) | Total Per Trip |
| (M=H+I+J+K+L) | Total For All Trips |
(N=M*B )
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
| $ - | $ - | $ - | $ - |
TOTAL TRAVEL $ -
Travel Assumptions:
&"Arial,Bold"&12CMS-RFP-2010-0016 Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC)
Attachment J-16 CLIN 0007 Cost Proposal Template &P
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