RFP_PFDC_Exhibit_E-2.xlsx

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Attached to
Recovery - HITECH Payment File Development Contractor Federal contract opportunity
Solicitation number
HHSM-500-2015-RFP-0110
Issued by
Department of Health and Human Services Centers for Medicare and Medicaid Services

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RFP PFDC Exhibit E-2

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CLIN 0001 Base Year

Exhibit E.2
Travel Breakdown
Reason for TripEmployee NameTravel To/FromTravel Dates - From/ToAirfareHotel Rate Per Day Per FTRNumber of NightsTotal Hotel (Plus Appl. Tax if Known)Meals & Incidentals Per Diem Per FTR# of Days M/I Per DiemTotal Per Diem (3/4 for 1st & last day)Car RentalMileage To/From Home AirportHome Airport ParkingTrans. To/From Dest. AirportOtherTotalDO NOT PRINT

Total $ - 0

&"Times New Roman,Bold Italic"(Company Name) &"Times New Roman,Regular"RFP-CMS-2010-0031 PFDC&"Times New Roman,Bold Italic"

Date should be date sent to OAGM. Don't use date button. Page &P of &N

CLIN 0002 Option Year 1

Exhibit E.2
Travel Breakdown
Reason for TripEmployee NameTravel To/FromTravel Dates - From/ToAirfareHotel Rate Per Day Per FTRNumber of NightsTotal Hotel (Plus Appl. Tax if Known)Meals & Incidentals Per Diem Per FTR# of Days M/I Per DiemTotal Per Diem (3/4 for 1st & last day)Car RentalMileage To/From Home AirportHome Airport ParkingTrans. To/From Dest. AirportOtherTotalDO NOT PRINT

Total $ - 0

&"Times New Roman,Regular"RFP-CMS-2010-0031 PFDC&"Times New Roman,Bold Italic"

Date should be date sent to OAGM. Don't use date button. Page &P of &N

CLIN 0003 Option Year 2

Exhibit E.2
Travel Breakdown
Reason for TripEmployee NameTravel To/FromTravel Dates - From/ToAirfareHotel Rate Per Day Per FTRNumber of NightsTotal Hotel (Plus Appl. Tax if Known)Meals & Incidentals Per Diem Per FTR# of Days M/I Per DiemTotal Per Diem (3/4 for 1st & last day)Car RentalMileage To/From Home AirportHome Airport ParkingTrans. To/From Dest. AirportOtherTotalDO NOT PRINT

Total $ - 0

&"Times New Roman,Regular"RFP-CMS-2010-0031 PFDC&"Times New Roman,Bold Italic"

Date should be date sent to OAGM. Don't use date button. Page &P of &N

CLIN 0004 Option Year 3

Exhibit E.2
Travel Breakdown
Reason for TripEmployee NameTravel To/FromTravel Dates - From/ToAirfareHotel Rate Per Day Per FTRNumber of NightsTotal Hotel (Plus Appl. Tax if Known)Meals & Incidentals Per Diem Per FTR# of Days M/I Per DiemTotal Per Diem (3/4 for 1st & last day)Car RentalMileage To/From Home AirportHome Airport ParkingTrans. To/From Dest. AirportOtherTotalDO NOT PRINT

Total $ - 0

&"Times New Roman,Regular"RFP-CMS-2010-0031 PFDC&"Times New Roman,Bold Italic"

Date should be date sent to OAGM. Don't use date button. Page &P of &N

CLIN 0005 Option Year 4

Exhibit E.2
Travel Breakdown
Reason for TripEmployee NameTravel To/FromTravel Dates - From/ToAirfareHotel Rate Per Day Per FTRNumber of NightsTotal Hotel (Plus Appl. Tax if Known)Meals & Incidentals Per Diem Per FTR# of Days M/I Per DiemTotal Per Diem (3/4 for 1st & last day)Car RentalMileage To/From Home AirportHome Airport ParkingTrans. To/From Dest. AirportOtherTotalDO NOT PRINT

Total $ - 0

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