Cost Proposal Form - WSH Dentistry Serrvices (C2303).xlsx

This is a Cost Proposal Form for Western State Hospital (WSH) Dentistry Services, referenced as RFP 729 2100000341. The proposal solicits dental services for an initial term covering Fiscal Year 2022. The scope of work requires qualified personnel in two staff categories: Dentists and Dental Hygienists, each with an estimated 250 hours per fiscal year. The form provides a structured format for vendors to submit staffing plans, including names, titles, hourly rates, and estimated annual hours for each position, with calculations for total costs per staff member and overall FY22 pricing.

Vendors are required to submit hourly rates for dental professionals and project total annual costs based on the 250-hour utilization estimate per position. The form mandates submission by an authorized representative of the organization, including signature, printed name, title, and date. Supporting documentation is strongly encouraged to substantiate the proposed rates and qualifications. The document also references multiple other RFPs within the same submission package, including forensic accounting, managed care consulting services, and actuarial services, indicating this is part of a larger multi-service procurement initiative.