RFP ATTACHMENTS 14-24 Oct 06 2011.pdf

ATTACHMENT 14

OFFICE OF SMALL AND DISADVANTAGED BUSINESS UTILIZATION

SMALL BUSINESS SUBCONTRACTING PLAN

The following outline meets the minimum requirements of section 8(d) of the Small Business Act, as amended, and implemented by the Federal Acquisition Regulations (FAR) Subpart 19.7. The U.S.

Department of Health and Human Services (HHS), Office of Small and Disadvantaged Business Utilization (OSDBU) recommend offerors use the following format to submit proposed Individual Subcontracting Plans, including modifications. It is not intended to replace any existing Corporate/Commercial Plan that is more extensive. A subcontracting Plan is required if the estimated cost of the contract may exceed $650,000 ($1,500,000 for construction) Small businesses are excluded. Questions should be forwarded to the Contracting Officer or Operating Division (OPDIV) Small Business Specialist.

HHS Operating Division (OPDIV):

SOLICITATION OR CONTRACT NUMBER:

DA"rE OF PLAN:

CONTRACTOR:

ADDRESS: __________________________________________________

STATE/ZIP CODE,________________________

DUNN & BRADSTREET NUMBER:

ITEM/SERVICE (Description):

NEWIINITIAL CONTRACT

PERIOD OF CONTRACT PERFORMANCE (MM/DD/YYYY - MM/DD/YYYY):__________

Base (if options apply) "t'__________ Performance Period/Quantity ______

Option 1: $_________ Performance Period/Quantity -'-_____

Option 2: $_________ Performance Period/Quantity ______

Option 3: ...._-'--________ Performance Period/Quantity ______

Option 4: $__________ Performance Period/Quantity ______

$________-,--_ Total Contract Cost

CONTRACT MODIFICATION (if applicable)

NEW PERIOD OF CONTRACT PERFORMANCE (MM/DD/YYYY - MM/DD/YYYY) : ________

Original/Base Performance Period/Quantity __- __

Modification Performance Period/Quantity _____

Task Order $_________ Performance Period/Quantity _____

Modified Total Contract Cost

Failure to include the essential information of FAR Subpart 19.7 may be cause for either a delay in acceptance or the rejection of a bid or offer when a subcontracting plan is required.

"SUBCONTRACT," as used in this clause, means any agreement (other than one involving an employer-employee relationship) entered into by a Federal Government prime contractor or subcontractor requesting supplies or services required for performance of the contract or subcontract.

If assistance is needed to locate small business sources, contact the Small Business Specialist (SBS) supporting the OPDIV. SBS contact information is located on the OSDBU website (http://www.hhs.gov/about/smallbusiness/osdbustaff.html) or you may contact the OSDBU headquarters at (202) 690-7300.

HHS current subcontracting goal is 28.0% for small business (hereafter referred to as SB), 5.00% for Small Disadvantaged Business, including 8(a) Program Participants, Alaska Native Corporations (ANC) and Indian Tribes (hereafter referred to as SDB), 5.00% for women-owned business and economically disadvantaged women-owned business (hereafter referred to as WOSB), 3.00% HubZone bUSiness (hereafter referred to as HUBZone), 3.00% Veteran Owned Small Business (hereafter referred to as VOSB) and 3.00% service disabled veteran-owned small business (hereafter referred to as SDVOSB) concerns for Fiscal Year (FY) 2011. For this procurement, HHS expects all proposed subcontracting plans to contain at a minimum the aforementioned percentages.

Revised December 2010 http://www.hhs.gov/about/smallbusiness/osdbustaff.html

These percentages shall be expressed as percentages of the total estimated subcontracting dollars.

1. Type of Plan (check one)

__ Individual plan (all elements developed specifically for this contract and applicable for the full term of this contract).

__ Master plan (goals developed for this contract) all other elements standardized and approved by a lead agency Federal Official; must be renewed every three years and contractor must provide copy of lead agency approval.

__ Commercial products/service plan (goals are negotiated with the initial agency on a company-wide basis rather than for individual contracts) this plan applies to the entire production of commercial service or items or a portion thereof.

The contractor sells commercial products and services customarily used for non government purposes. The plan is effective during the offeror's fiscal year (attach a copy). The Summary Subcontracting Report (SSR) must include a breakout of subcontracting prorated for HHS and other Federal agencies.

2. Goals

Below indicate the dollar and percentage goals for Small Business, Small Disadvantaged (SDB) including Alaska Native Corporations and Indian Tribes, Woman-owned and Economically Disadvantaged Women-Owned (WOSB), Historically Underutilized Business Zone (HUBZone), Service-Disabled Veteran-owned (SDVOSB) small businesses. and "Other than small business" (Other) as subcontractors. Indicate the base year and each option year, as specified in FAR 19.704 or project annual subcontracting base and goals under commercial plans. If any contract has more four options, please attach additional sheets which illustrate dollar amounts and percentages.

a. Total estimated dollar value of ALL planned subcontracting, i.e., with ALL types of concerns under this contract is (Base Period - if options apply).

FY Option FY _2nd Option FY _3rd Option FY _4th Option

b. Total estimated dollar value and percent of planned subcontracting with SMALL BUSINESSES (including SDB, WOSB, HUBZone, VOSB and SDVOSB): (% of "a") $ ________ and ________% (Base Period - if options apply)

FY _1st Option FY _2nd Option FY _3rd Option FY _4th Option

Revised December 2010

c. Total estimated dollar value and percent of planned subcontracting with SMALL DISADVANTAGED BUSINESSES: C% of "a") $ and ________% (Base Period - if options apply)

FY _1st Option FY _2nd Option FY _3rd Option FY _4th Option

d. Total estimated dollar value and percent of planned subcontracting with WOMAN-OWNED SMALL BUSINESSES: (% of "a") $ and ________% (Base Period - if options apply)

FY _1 st Option FY _2nd Option FY _3 rd Option FY _4th Option

e. Total estimated dollar and percent of planned subcontracting with HUBZone SMALL

BUSINESSES:

(% of "a") $ and % (Base Period - if options apply)

FY Option FY _2nd Option FY _3 rd Option FY _4th Option

f. Total estimated dollar and percent of planned subcontracting with VETERAN OWNED SMALL BUSINESSES: (% of "a") $ and ________% (Base Period - if options apply)

FY Option FY _2nd Option FY _3 rd Option FY _4th Option

g. Total estimated dollar and percent of planned subcontracting with SERVICE DISABLED VETERAN-OWNED SMALL BUSINESSES: (% of "a") $ ________ and % (Base Period - if options apply)

FY _1st Option FY _2nd Option FY _3rd Option FY _4th Option

h. Total estimated dollar and percent of planned subcontracting with "OTHER THAN SMALL BUSINESSES" (As defined by the Small Business Administration as "any entity that is not classified as a small business. This includes large businesses, state and local governments, non-profit organizations, public utilities, educational institutions and foreign-owned firms.; (% of "a") $ and % (Base Period - if options apply)

FY _1st Option FY Option FY _3rd Option FY _4th Option

Note: Federal prime contract percentage goals may serve as objectives for subcontracting goal development:

i. Provide a description of ALL the products and/or services to be subcontracted under this contract, and indicate the size and type of business supplying them (check all that apply):

Products and/or Services Other Small Business

SDB WOSB Hubz VOSB SDVOSB i

j. Provide a description of the method used to develop the subcontracting goals for SB, SDB, WOSB, HUBZone and SDVOSB concerns. Address efforts made to ensure that maximum practicable subcontracting opportunities have been made available for those concerns and explain the method used to identify potential sources for solicitation purposes. Explain the method and state the quantitative basis (in dollars) used to establish the percentage goals. Also, explain how the areas to be subcontracted to SB, WOSB, HUBZone, VOSB and SDVOSB concerns were determined, how the capabilities of these concerns were considered contract opportunities and how such data comports with the cost proposal. Identify any source lists or other resources used in the determination process. (Attach additional sheets, if necessary.)

k. Indirect costs have __ have not __ been included in the dollar and percentage subcontracting goals above (check one).

I. If indirect costs have been included, explain the method used to determine the proportionate share of such costs to be allocated as subcontracts to SB, SDB, WOSB, HUBZone, VOSB and SDVOSB concerns:

3. Program Administrator:

NAME:

TITLE:

ADDRESS:

TELEPHONE: .

E-MAIL:

Duties: Does the individual named above have general overall responsibility for the company's subcontracting program, i.e., developing, preparing, and executing subcontracting plans and monitoring performance relative to the requirements of those subcontracting plans and perform the following duties? (If NO is checked, please who in the company performs those duties, or indicate why the duties are not performed in your company on a separate sheet of paper and submit with the proposed subcontracting plan.)

a. Developing and promoting company-wide policy initiatives that demonstrate the company's support for awarding contracts and subcontracts to SB, SDB, WOSB, HUBZone, VOSB and SDVOSB concerns; and for assuring that these concerns are included on the source lists for solicitations for products and services they are capable of providing; _yes no

b. Developing and maintaining bidder source lists of SB, SDB, WOSB, HUBZone, VOSB and SDVOSB concerns from all possible sources; _yes _ no

c. Ensuring periodic rotation of potential subcontractors on bidder's lists; _ yes _ no

d. Assuring that SB, SDB, WOSB, HUBZone, VOSB and SDVOSB businesses are included on the bidders' list for every subcontract solicitation for products and services that they are capable of providing. _ yes _ no

e. Ensuring that Requests for Proposals (RFPs) are designed to permit the maximum practicable participation of SB, SOB, WOSB, HUBZone, VOSB and SOVOSB concerns.

_yes _ no

f. Reviewing subcontract solicitations to remove statements, clauses, etc., which might tend to restrict or prohibit small, Sea), SOB, WOSB, HUBZone, VOSB and SOVOSB small business participation. _ yes _ no

g. Accessing various sources for the identification of SB, SOB, WOSB, HUBZone, VOSB and SOVOSB concerns to include the Central Contractor Registration (http://www.ccr.qovl), local small business and minority associations, local chambers of commerce and Federal agencies' Small Business Offices; _ yes no

h. Establishing and maintaining contract and subcontract award records; yes _ no

i. Participating in Business Opportunity Workshops, Minority Business Enterprise Seminars, Trade Fairs, Procurement Conferences, etc; _ yes _ no

j. Ensuring that SB, SOB, WOSB, HUBZone, VOSB and SOVOSB concerns are made aware of subcontracting opportunities and aSSisting concerns in preparing responsive bids to the company; _ yes _ no

k. Conducting or arranging for the conduct of training for purchasing personnel regarding the intent and impact of Section Sed) of the Small Business Act, as amended; _ yes _ no

I. l"1onitoring the company's subcontracting program performance and making any adjustments necessary to achieve the subcontract plan goals; __yes __ no m.Preparing and submitting timely, required subcontract reports; __ yes __ no

n. Conducting or arranging training for purchasing personnel regarding the intent and impact of Sed) of the Small Business Act on purchasing procedures; yes _ no

o. Coordinating the company's activities during the conduct of compliance reviews by Federal agencies; and _ yes _ no

p. Other duties:

4. Equitable Opportunity

Oescribe efforts the offeror will undertake to ensure that SB, SOB, WOSB, HUBZone, VOSB and SOVOSB concerns will have an equitable opportunity to compete for subcontracts.

These efforts include, but are not limited to, the following activities: .

Revised December 2010 http://www.ccr.qovl

a. Outreach efforts to obtain sources:

1. Contact minority and small business trade associations; 2) contact business development organizations and local chambers of commerce; 3) attend SB, SDB, WOSB, HUBZone, VOSB and SDVOSB procurement conferences and trade fairs; 4) review sources from the Central Contractor Registration (http://www.ccr.govl); 5) review sources from the Small Business Administration (SBA), Central Contractor Registration (CCR); 6) Consider using other sources such as the National Institutes of Health (NIH) e-Portals in Commerce, (e-PIC), (http://epic.od.nih.govl). The NIH e-PIC is not a mandatory source; however, it may be used at the offeror's discretion; and 7) Utilize newspaper and magazine ads to encourage new sources.

b. Internal efforts to guide and encourage purchasing personnel:

1. Conduct workshops, seminars and training programs;

2. Establish, maintain, and utilize SB, SD!3, WOSB, HUBZone, VOSB and SDVOSB source lists, guides, and other data for soliCiting subcontractors; and

3. Monitor activities to evaluate compliance with the subcontracting plan.

Additional efforts:

5. Flow Down Clause

The contractor agrees to include the provisions under FAR 52.219-8, "Utilization of Small Business Concerns," in all acquisitions exceeding the simplified acquisition threshold that offers further subcontracting opportunities. All subcontractors, except small business concerns, that receive subcontracts in excess of $650,000 ($1,500,000 for construction) must adopt and comply with a plan similar to the plan required by FAR 52.219-9, "Small Business Subcontracting Plan./1 Note: In accordance with FAR 52.212-5(e) and 52.244 6(c) the contractor is not required to include flow-down clause FAR 52.219.-9 if it is subcontracting commercial items.

6. Reporting and Cooperation

The contractor gives assurance of 1) cooperation in any studies or surveys that may be required; 2) submission of periodic reports which illustrate compliance with the subcontracting plan; 3) submission of its Individual Subcontracting Report (ISR) and Summary Subcontract Report (SSR); and 4) subcontractors submission of ISRs and SSRs.

ISRs and SSRs shall be submitted via the Electronic Subcontracting Reporting System (eSRS) website https:llesrs.symplicity.comlindex? tab=signin&cck=l

Revised December 2010 https:llesrs.symplicity.comlindex http://epic.od.nih.govl http://www.ccr.govl

Reporting Period Report Due Due Date

Oct 1 - Mar 31 IsR 4/30

Apr 1 - Sept 30 IsR 10/30

Oct 1 - Sept 30 ssR 10/30

Contract Completion

Year End sDB Report

30 days after completion

Please refer to FAR Part 19.7 for instruction concerning the submission of a Commercial Plan: ssR is due on 10/30 each year for the previous fiscal year ending 9/30.

a. Submit IsR (bi-annually) for the awarding Contracting Officer's review and acceptance via the esRs website.

b. Currently, ssR (annually) must be submitted for the HHs esRs Agency Coordinator review and acceptance via the esRs website. (Note: Log onto the OsDBU website to view the HHs Agency Coordinator contact information (http://www.hhs.gov/about/smallbusiness/osdbustaff.html). .

Note: The Request for Proposal (RFP) will indicate whether a subcontracting plan is required. Due to the nature and complexity of many HHS contracts, particularly the Centers for Medicare and Medicaid (CMS), the contractor may not be required to submit its subcontracting reports through the eSRS. The Contracting Officer will confirm reporting requirements prior to the issuance of an award. For more information, contact Teneshia Alston, Agency Coordinator-eSRS (Teneshia.Alston@HHS.GOV).

7. Record keeping

FAR 19;704(a) (11) requires a list of the types of records your company will maintain to demonstrate the procedures adopted to comply with the requirements and goals in the subcontracting plan. The following is a recitation of the types of records the contractor will maintain to demonstrate the procedures adopted to comply with the requirements and goals in the subcontracting plan. These records will include, but not be limited to, the following:

a. sB, sDB, WOsB, HUBZone, VOsB and sDVOsB source lists, guides and other data identifying such vendors;

b. Organizations contacted in an attempt to locate sB, sDB, WOsB, HUBZone, VOsB and sDVOsB sources;

c. On a contract-by-contract basis, records on all subcontract solicitations over $100,000, which indicate for each solicitation (1) whether sB, sDB, WOsB, HUBZone, VOsB and/or sDVOsB concerns were solicited, if not, why not and the reasons solicited concerns did not receive subcontract awards;

Revised December 2010 mailto:Teneshia.Alston@HHS.GOV http://www.hhs.gov/about/smallbusiness/osdbustaff.html

d. Records to support other outreach efforts, e.g., contacts with minority and small business trade associations, attendance at small and minority business procurement conferences and trade fairs;

e. Records to support internal guidance and encouragement provided to buyers through (1) workshops, seminars, training programs, incentive awards; and (2) monitoring performance to evaluate compliance with the program and requirements; and

f. On a contract-by-contract basis, records to support subcontract award data including the name, address, and business type and size of each subcontractor.

(This is not required on a contract-by-contract basis for commercial plans.)

g. Other records to support your compliance with the subcontracting plan: (Please describe)

8. Timely Payments to Subcontractors

FAR 19.702 requires your company to establish and use procedures to ensure the timely payment of amounts due pursuant to the terms of your subcontracts with SB concerns, SDB, WOSB, HUBZone, VOSB and SDVOSB concerns.

Your company has established and used such procedures: ____ yes _____ no

9. Description of Good Faith Effort

Maximum practicable utilization of SB, SDB, WOSB, HUBZone, VOSB and SDVOSB concerns as subcontractors in Government contracts is a matter of national interest with both social and economic benefits. When a contractor fails to make a good faith effort to comply with a subcontracting plan, these objectives are not achieved, and 15 U.S.C. 637(d) (4) (F) directs that liquidated damages shall be paid by the contractor. In order to demonstrate your compliance with a good faith effort to achieve the SB, SDB, WOSB, HUBZone, VOSB and SDVOSB small business subcontracting goals, outline the steps your company plans to take. These steps will be negotiated with the contracting official prior to approval of the plan.

SIGNATURE PAGE

Signatures Required:

This subcontracting plan was submitted by:

Signature:

Typed/Print Name: ________________________

Title:

Date:

This plan was reviewe~ by:

Typed/Print Name: _________________~________

Title: Contracting Officer Date: ___________

This p,lan was reviewed by:

Typed/Print Name: ___________________________

Title: HHS Small Business Specialist Date:

This plan was reviewed by:

Typed/Print Name: _________________________

Title: Small Business Administration Procurement Center Representative

This plan was approved by:

Typed/Print Name: _________________________

Title: Contracting Officer Date: ___________

· BREAKDOWN OF PROPOSED ESTIMATED COST (PLUS FEE) AND LABOR HOURS - 2... Page 1 of 3

ATTACHMENT 15

BREAKDQWN__QFPRQ~QSEDESTIMATED_CQSTJPLU:S

FEE) AND LABOR HOURS

INSTRUCTIONSFOR USE OF THE FORMAT

1. Refer to Business Proposal Instructions, Section L of this solicitation. The Instructions contain the requirements for proper submission of cost/price data which must be adhered to.

2. This format has been prepared as a universal guideline for all solicitations issued by the National Cancer InstitUte. It may require amending to meet the specific requirements of this solicitation. For example, this solicitation may require the submission of cost/price data for three years listed on this form. (See Section L.l., General Information for the estimated duration of this project.) If this solicitation is phased, identify each phase in addition to each year. Total each year, phase, and sub-element. .

3. This format must be used to submit the breakdown of all proposed estimated cost elements.

List each cost element and sub-element for direct costs, indirect costs and fee, if applicable. In addition, provide detailed calculations for all items. For example:

a. For all personnel, list the name, title, rate per hour and number of hours proposed. If a pool of personnel is proposed, list the composition of the pool and how the cost proposed was calculated. List the factor used for prorating Year One and the escalation rate applied between years.

Offeror's proposal should be stated in the same terms as will be used to account for and record direct labor under a contract (i.e. percentage of effort is used for most faculty and professional employees at educational institutions). If percentages of effort are used, the basis to which such percentages are applied must also be submitted by the offeror. The attached format should be revised to accommodate direct labor proposed as a percentage of effort.

b. For all materials, supplies, and other direct costs, list all unit prices, etc., to detail how the calculations were made.

c. For all indirect costs, list the rates applied and the base the rate is applied to.

d. For all travel, list the specifics for each trip.

e. For any subcontract proposed, submit a separate breakdown format.

f. Justification for the need of some cost elements may be listed as an attachment, i.e., special equipment, above average consultant fees, etc.

4. If the Government has provided "uniform pricing assumptions" for this solicitation, the offeror must comply with and identify each item.

BREAKDOWN OF PROPOSED ESTIMATED COSTS (PLUS FEE) AND LABOR HOURS ATTACHMENT 15

http://oamp.od.nih.gov/contracts/BUSCOST.HTM 9/1412011 http://oamp.od.nih.gov/contracts/BUSCOST.HTM

BREAKDOWN OF PROPOSED ESTIMATED COST (PLUS FEE) AND LABOR HOURS - 2... Page 2 of 3

An electronic spreadsheet is available to assist you in the preparation of your business proposal. It is in EXCEL format and has instructions for use and submission. Prior to using this spreadsheet discuss it with the cognizant Contract Specialist responsible for the RFP of interest to you.

ELECTRONIC CONTRACT:6USINESSPROP.OSAL

()lttp;Lfq!lIDR.qd~njb.!gQvlDiyi~j(m/DYAS/~R.~b~x.c1Jb) IMPORTANT NOTE: Save this file on your computer before opening, otherwise, you will be prompted for a user name and a password and you will lose all the data you may have inserted~ .

FORMAT:

RFPNumber:

Organization:

BREAKDOWN OF PROPOSED ESTIMATED COST (PLUS FEE) AND LABOR HOURS

II COST ELEMENT "Year I II Year 2 II TotalII I IDIRECT LABOR: I HoursII Rate II ~~~ 11~~~s Amt.

~or Category II 1/

(Title and N ame-- use additional pages as necessary) I

IDIRECT LABOR COST /I $ 11$ $

$IMATERIAL COST 11$ II $

ITRAVEL COST II $ 11$ /$

OTHER (Specify) 1$ II $

" $ IOTHER (Specify) I!II $ 11$ II $

ITOTAL DIRECT COST /I $ 11$ 11$ I

FRINGE BENEFIT COST (if applicable) % of

Direct Labor Cost

I Ii iI Ii I

BREAKDOWN OF PROPOSED ESTIMATED COSTS (PLUS FEE) AND LABOR HOURS ATTACHMENT 15

9114/2011http://oamp.od.nih.gov/contracts/BUSCOST.HTM

BREAKDOWN OF PROPOSED ESTIMATED COST (PLUS FEE) AND LABOR HOURS - 2 ... Page 3 of 3

I

INDIRECT COST

% of Total Direct Cost 1$ 11$ 11$

ITOTAL COST

11$ II $

FEE:

(if applicable) % of Total Est. Cost $ $ $

GRAND TQTALESTIMATEDCQST

(PLUS FIXED FEE)

[contracts/u pdate.htm]

BREAKDOWN OF PROPOSED ESTIMATED COSTS (PLUS FEE) AND LABOR HOURS ATTACHMENT 15

9/1412011http://oamp.od.nih.gov/contracts/BUSCOST.HTM

;9TTI9CflI11GAlT IS hHp:/1 OQ~p.od. nl h. jOv/ b i..;;s;o() /:DFfI<;:/ spsA eyc!. X (S

INSTRUCTIONS

OMB Control No. 9000-0013

How to use this Excel file:

(Updated 10/9/2008)

IMPORTANT NOTE: If you have opened this file before saving on your computer, you will be prompted for a user name and a password and you will lose all the data you may have inserted. Please close the file and click on the link again and save before opening.

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 reviewlaward process and perhaps reduce the number of questions we need to ask in order to understand your proposal. We understand that one spreadsheet format can not fit every situation; however, we have attempted to create a simple 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. There are more specific instructions on specific cost element pages where applicable.

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.

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 tract 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. ConSUltants should be proposed on the conSUltants worksheet. not the labor worksheets.

The proposed amounts must be based on current payroll information which shows hourly, monthly, or annual ratelsalary for each proposed (named) individuals. Acceptable documentation includes anyone 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 at a later date.

If the proposed positions have not been filled or are to be named or 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 at a later date. Increases for the to be named or hired 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 website contains information which will assist you in computing indirect rates:

http://oamp.od.nih.gov/dfas/ldCSubmission.asp

Please do not submit your indirect proposal to the Division of Financial Advisory Services at this time.

Points of Contact

If you have any questions regarding this Excel file, please contact Cindi Brown (301-496-4494) email at CB25B@NIH.GOV.

If you have contracting questions, please call the NIH Contracting Official who is listed in the RFP.

mailto:CB25B@NIH.GOV http://oamp.od.nih.gov/dfas/ldCSubmission.asp

SUMMARY OF PROPOSED COSTS

** Contractor's Name ** RFP No.

PERIOD I PERIOD II PERIOD III PERIOD IV PERIODV PER!ODVI PERIOD VII TOTAL

... Period ( dates II 11112007 1/112008 1/112009 111/2010 1/112011 1/1/2012 1/1/2013

Through Through Through Through Through Through Through 12131/2007 12131/2008 12131/2009 12131/2010 1213112011 12131/2012 12131/2013

Direct Labor· Percent of Effort Fringe Benefits - Percent of Effort Direct Labor - Hourly Fringe Benefits - Hourly Total Direct Labor & Fringe Benefits *Overhead

Materials and Supplies Professional Travel Equipment Consultants Other Direct Costs Patient Care Costs Subcontracts Total Other Direct Costs

Subtotal: Direct Labor. Fringe Benefits. Overhead. & other DIrects

Exclusion(s) From Base For G&A Atsted Base for G&A

G&A Total Proposed Cost El<cludlng Fee Proposed FeelProfit

$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 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% 0 0% 0

Total Proposed Cost Plus Fee/Profit $0 $0 $0 $0 $0

*' INot all organizations allocate Indirect cost in the same way. It is Important that 'Iou use the Indirect rate structure applicable to your organization. For example, if you have a two tier indirect rate structure, then you will use a two tier structure when proposing Indirect costs.

Generally, Universities and Non-Profits have fringe benefit and G&A (or sometimes called F&A) rates, while For-Profit Comoanles 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.

*' tyou-~~~e questions regarding indirect (F&A) rates see website: http://oamp.od.nlh.gov/dfaslldCSubmission.asp

Please insert the Company's name and the RFP #.

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

$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 0% 0 0% 0 0

0 0 0

O"AI 0 0% 0 0

$0 $0 $0 http://oamp.od.nlh.gov/dfaslldCSubmission.asp

SUMMARY OF DIRECT LABOR

AND FRINGE BENEFITS

PERCENT OF EFFORT

** Contractor's Name ** RFP No.

EMPLOYEE POSITION

CURRENT ADJUSTED

BASE SALARY BASE SALARY

PERCENT OF

EFFORT

PERIOD I'

111/2007 Through 12/31/2007

NUMBER SALARY FRINGE FRINGE

MONTHS COST RATE COST

PERIOD 11*

111/2008 Through 12131/2008

II PERCENT OF NUMBER SALARY FRINGE FRINGE

EFFORT MONTHS COST RATE COST

1 $0 $0 0% 12.00 $0 0% $0 0% 12.00 $0 0% $0 i 2 0 0 0% 12.00 0 0% 0 0% 12.00 0 0°,(, 0 3 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 4 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 5 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 6 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 7 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 8 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 9 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

10 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 11 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 12 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 13 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 14 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 15 0 0 0% 12.00 0 0% 0 0% 12.00 0 0°,(, 0 16 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 17 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 18 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 19 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 20 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 21 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 22 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 23 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 24 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 25 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 26 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 27 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 28 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 29 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 30 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 31 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

SUBTOTALS 0% I I $()J L _$0 _O~I L $oJ L~O

THE FOLLOWING BOXES IN COLUMN "0" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual anniversary dates differ, the adjusted base salaries must be entered individually in Column "0" of the spreadsheet and explained in the budget justification)

ANNUAL INCREASE FACTOR:I 0.00% I+- Iinsert annual cost of living % andlor merit increases as applicable and explain the % in the budget justification.

ANNUAL INCREASE DATE: I 00/00/00 +-It~sert annual increase date.

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE I 0 =:J +-Ilnsert number of months at the new salary ...

·Adjust the number of months per period as recommended in the RFP.

PERCENT OF EFFORT

** Contractor's Name *.. RFP No.

CURRENT ADJUSTED

EMPLOYEE POSITION BASE SALARY BASE SALARY

PERIOD 111*

11112009 ThroughIPERCENT OF NUMBER SALARY

EFFORT MONTHS COST

1213112009

FRINGE FRINGE

RATE COST

PERIOOIV*

11112010 Through 1213112010IPERCENT OF NUMBER SALARY FRINGE FRINGE

EFFORT MONTHS COST RATE COST

1 $0 $0 0% 12.00 $0 0% $0 0% 12.00 $0 0% $0 2 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 3 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 4 0 0 0% 12.00 0 0°,(, 0 0% 12.00 0 0% 0 5 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 6 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 7 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 8 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 9 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

10 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 11 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 12 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 13 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 14 0 0 0% 12.00 0 0°,(, 0 0% 12.00 0 0% 0 15 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 16 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 17 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 18 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 19 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 20 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 21 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 22 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 23 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 24 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 25 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 26 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 27 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 28 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 29 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 30 0 0 0% 12.00 0 0% 0 0°,(, 12.00 0 0% 0 31 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

SUBTOTALS = 0% I I $0 I I $0 0% I I $0 I I $0

THE FOLLOWING BOXES IN COLUMN "0" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual anniversary dates differ. the adjusted base salaries must be entered individually in Column "0" of the spreadsheet and explained in the budget justification)

ANNUAL INCREASE FACTOR:~.66%

ANNUAL INCREASE DATE:I 66i6oro:]

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE I 0

'Adjust the number of months per period as recommended in the RFP.

http:FACTOR:~.66

AND FRINGE BENEFITS

PERCENT OF EFFORT

** Contractor's Name ** RFP No.

CURRENT ADJUSTED

EMPLOYEE POSITION BASE SALARY BASE SALARY

PERIODV·

111/2011 ThroughIPERCENT OF NUMBER SALARY

EFFORT MONTHS COST

1213112011

FRINGE FRINGE

RATE COST

PERIODVI* :

11112012 Through 12131/2012IPERCENT OF NUMBER SALARY FRINGE FRINGE I

EFFORT MONTHS COST RATE COST

1 $0 $0 0% 12.00 $0 0% $0 0% 12.00 $0 0% $0 2 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 3 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 4 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 5 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 6 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 7 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 8 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 9 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

10 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 11 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 12 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 13 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 14 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 01 15 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 16 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 17 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 18 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 19 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 20 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 21 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 22 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 23 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 24 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 25 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 26 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 27 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 28 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 29 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 30 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0 31 0 0 0% 12.00 0 0% 0 0% 12.00 0 0% 0

SUBTOTALS = 0% I I $QJ 1_ $0 ,__ 0% I I $oJ ~_$O~

THE FOLLOWING BOXES IN COLUMN "0" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY. AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual anniversary dates differ. the adjusted base salaries must be entered individually in Column "0" of the spreadsheet and explained in the budget justification)

ANNUAL INCREASE FACTOR:I 0.00%1

ANNUAL INCREASE DATE:I 00/00100

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE I 0

'Adjust the number of months per period as recommended in the RFP.

PERCENT OF EfFORT

** Contractor's Name PERIODVII*

** RFP No. 1/112013 Through 12/3112013 TOTAL TOTAL

CURRENT ADJUSTED /PERCENT OF NUMBER SALARY FRINGE FRINGE SALARY FRINGE

EMPLOYEE POSITION BASE SALARY BASE SALARY EFFORT MONTHS COST RATE COST COST COST

1 $0 $0 0% 12.00 $0 0% $0 $0 $0 2 0 0 0% 12.00 0 0% 0 0 0 3 0 0 0% 12.00 0 0% 0 0 0 4 0 0 0% 12.00 0 0% 0 0 0 5 0 0 0% 12.00 0 0% 0 0 0 6 0 0 0% 12.00 0 0% 0 0 0 7 0 0 0% 12.00 0 0% 0 0 0 8 0 0 0% 12.00 0 0% 0 0 0 9 0 0 0% 12.00 0 0% 0 0 0

10 0 0 0% 12.00 0 0% 0 0 0 11 0 0 0% 12.00 0 0% 0 0 0 12 0 0 0% 12.00 0 0% 0 0 0 13 0 0 0% 12.00 0 0% 0 0 0 14 0 0 0% 12.00 0 0% 0 0 0 15 0 0 0% 12.00 0 0% 0 0 0 16 0 0 0% 12.00 0 0% 0 0 0 17 0 0 0% 12.00 0 0% 0 0 0 18 0 0 0% 12.00 0 0% 0 0 0 19 0 0 0% 12.00 0 0% 0 0 0 20 0 0 0% 12.00 0 0% 0 0 0 21 0 0 0% 12.00 0 0% 0 0 0 22 0 0 0% 12.00 0 0% 0 0 0 23 0 0 0% 12.00 0 0% 0 0 0 24 0 0 0% 12.00 0 0% 0 0 0 25 0 0 0% 12.00 0 0% 0 0 0 26 0 0 0% 12.00 0 0% 0 0 0 27 0 0 0% 12.00 0 0% 0 0 0 28 0 0 0% 12.00 0 0% 0 0 0 29 0 0 0% 12.00 0 0% 0 0 0 30 0 0 0% 12.00 0 0% 0 0 0 31 0 0 0% 12.00 0 0% 0 0 0

SUBTOTAlS = 0% I I $0 I I $0 $0 $0

THE FOLLOWING BOXES IN COLUMN "D" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the 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)

ANNUAL INCREASE FACTOR:I n-o:oO~

ANNUAL INCREASE DATE:I nOO7oo/oo

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE I 0

Hourlv Rates ** Contractor's Name *.. RFP No.

EMPLOYEE POSITION

CURRENT BASE ADJUSTED

HOURLY RATE HOURLY RATE

NUMBER

HOURS

PERIOD I

1/112007 Through 12131/2007

NUMBER SALARY FRINGE FRINGE

MONTHS COST RATE COST

PERIOD II

111/2008 Through 12131/2008

NUMBER NUMBER SALARY FRINGE FRINGE

HOURS MONTHS COST RATE COST

1 $0.00 $0.00 0.00 12.00 $0 0% $0 0.00 12.00 $0 0% $0 2 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °3 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °4 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °5 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °6 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °7 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °8 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °9 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °10 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °11 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °12 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °13 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °14 000 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °15 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °16 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °17 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °18 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °19 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °20 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °21 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °22 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °23 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °24 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °25 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °26 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °27 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °28 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °29 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °30 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °31 0.00 0.00 0.00 12.00 ° 0% ° 0.00 12.00 ° 0% °SUBTOTALS = 0.00 I I $0 I I $0 0.00 I I $0 I I $0

THE FOLLOWING BOXES IN COLUMN "0" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the 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) hosed YOllr direct work Year --I

NUMBER OF HOURS FOR FULL TIME EQUIVALENT: ....I--O~-.....,I

ANNUAL INCREASE FACTOR:. 0.00% .<11- Insert annual cost of living % andlor merit increases as applicable and explain the % in the budget justification.

ANNUALINCREASE DATE: I 00100100 I <II-- IInsert annual increase date.

~======~~~~~ NUMBER OF MONTHS AT NEXT ANNUAL INCREASEI ° <II-- IInsert number of months at the the new hourly rate.

"Adjust the number of months per period as recommended in the RFP.

Hourlv Rates

** Contractor's Name PERIOD III' PERIOD IV'

- RFPNo. 1/112009 Through 12131/2009 1/112010 Through 12131/2010 CURRENT BASE ADJUSTED NUMBER NUMBER SALARY FRINGE FRINGE NUMBER NUMBER SALARY FRINGE FRINGE

EMPLOYEE POSITION HOURLY RATE HOURLY RATE HOURS MONTHS COST RATE COST HOURS MONTHS COST RATE COST 1 $0.00 $0.00 0.00 12.00 $0 0% $0 0.00 12.00 $0 0% $0 2 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 0 0% 0 3 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 4 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 5 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 6 000 0.00 0.00 12.00 0 0% a 0.00 12.00 0 0% 0 7 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 8 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 9 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 0 0% 0

10 0.00 0.00 0.00 12.00 0 0% 0 000 12.00 0 0% 0 11 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 12 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 13 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 14 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 15 0.00 0.00 0.00 12.00 a 0% 0 0.00 12.00 0 0% a 16 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 17 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 18 0.00 000 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 19 0.00 0.00 0.00 12.00 a 0% 0 0.00 12.00 0 0% 0 20 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 21 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 0 0% 0 22 0.00 0.00 0.00 12.00 a 0% 0 0.00 12.00 0 0% 0 23 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 24 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 25 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 26 0.00 0.00 0.00 12.00 a 0% 0 0.00 12.00 0 0% 0 27 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 28 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 29 0.00 0.00 0.00 12.00 a 0% 0 000 12.00 0 0% 0 30 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0 31 0.00 0.00 0.00 12.00 0 0% 0 0.00 12.00 0 0% 0

SUBTOTALS 0.00 I I $0 I I $0 0.00 I I $0 I I $0

THE FOLLOWING BOXES IN COLUMN "D" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the 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)

NUMBER OF HOURS FOR FULL TIME EQUIVALENT: I 0

ANNUAL INCREASE FACTOR: 0.00%

ANNUALINCREASE DATE: r 00/00/00

NUMBER OF MONTHS AT NEXT ANNUAL INCREASEI 0

Hourlv Rates

** Contractor's Name PERIOD VI'PERIODV'

*'" RFP No. 1/112012 Through 12/31/2012111/2011 Through 12131/2011 CURRENT BASE ADJUSTED NUMBER NUMBER SALARY FRINGE FRINGENUMBER NUMBER SALARY FRINGE FRINGE

EMPLOYEE POSITION HOURLY RATE HOURLY RATE HOURS MONTHS COST RATE COST HOURS MONTHS COST RATE COST 1 $0.00 $0.00 0.00 12.00 $0 0% $0 0.00 12.00 $0 0% $0 2 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 a 0% a 3 0.00 0.00 0.00 12.00 a 0% 0 0.00 12.00 a 0% 0 4 0.00 0.00 0.00 12.00 0 0% 00.00 12.00 a 0% a 5 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 a 0% 0 6 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 0 0% 0 7 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 a 0% 0 8 0.00 000 0.00 12.00 a 0% 0 0.00 12.00 0 0% 0

0.00 12.00 a 0% a9 0.00 0.00 0.00 12.00 a 0% 0 10 000 0.00 0.00 12.00 a 0% a 0.00 12.00 a 0% 0 11 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 a 0% 0 12 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 0 0% 0 13 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 0 0% 0

14 0.00 0.00 0.00 12.00 0 0% 00.00 12.00 0 0% a 15 0.00 0.00 0.00 12.00 a 0% 00.00 12.00 a 0% a

0.00 12.00 0 0% 0 0.00 12.00 a 0% 016 0.00 0.00 17 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 a 0% 0 18 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 0 0% 0 19 0.00 0.00 0.00 12.00 a 0% a0.00 12.00 a 0% a 20 0.00 0.00 0.00 12.00 0 0% a 0.00 12.00 a 0% a

0.00 12.00 a 0% 021 0.00 0.00 0.00 12.00 a 0% a 22 0.00 0.00 0.00 12.00 a 0% 00.00 12.00 a 0% a 23 0.00 0.00 0.00 12.00 a 0% a 0.00 12.00 a 0% a

0.00 12.00 a 0% 024 0.00 0.00 0.00 12.00 a 0% a

0.00 12.00 0 0% 025 0.00 0.00 0.00 12.00 a 0% a

0.00 12.00 0 0% a26 0.00 0.00 0.00 12.00 a 0% a 000 1200 a 0% a27 0.00 0.00 0.00 12.00 a 0% a

0.00 12.00 a 0% 028 0.00 0.00 0.00 12.00 0 0% a

0.00 12.00 a 0% 0

0.00 12.00 a 0% 029 0.00 0.00

0.00 12.00 a 0% a30 0.00 0.00 0.00 12.00 a 0% a

0.00 12.00 0 0% a 0.00 12.00 0 0% 031 0.00 0.00

0.00 I I $0 I I $0SUBTOTALS = 0.00 I I $0 I I $0

THE FOLLOWING BOXES IN COLUMN "0" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the 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)

NUMBER OF HOURS FOR FULL TIME EQUIVALENT: I b

ANNUAL INCREASE FACTOR: 0.00%

ANNUAL INCREASE DATE: I ooio~

NUMBER OF MONTHS AT NEXT ANNUAL INCREASEI a

Hourlv Rates... __.... J • "'_ .._ --** Contractor's Name PERIODVU*

- RFP No. 1/1/2013 Through 1213112013 TOTAL TOTAL

CURRENT BASE ADJUSTED NUMBER NUMBER SALARY FRINGE FRINGE SALARY FRINGE

EMPLOYEE POSITION HOURLY RATE HOURLY RATE HOURS MONTHS COST RATE COST COST COST

1 $0.00 $0.00 0.00 12.00 $0 0% $0 $0 $0 2 0.00 0.00 0.00 12.00 0 0% a a 0 3 0.00 0.00 0.00 12.00 a 0% 0 0 0 4 0.00 0.00 0.00 12.00 0 0% a 0 a 5 0.00 0.00 0.00 12.00 a 0% 0 a 0 6 0.00 0.00 0.00 12.00 0 0% 0 a a 7 0.00 0.00 0.00 12.00 a 0% a a a 8 0.00 0.00 0.00 12.00 a 0% 0 a 0 9 0.00 0.00 0.00 12.00 a 0% a a 0

10 0.00 0.00 0.00 12.00 a 0% 0 a a 11 0.00 0.00 0.00 12.00 0 0% 0 a a 12 0.00 0.00 0.00 12.00 0 0% a a a 13 0.00 0.00 0.00 12.00 0 0% a a 0 14 0.00 0.00 0.00 12.00 a 0% a 0 a 15 0.00 0.00 0.00 12.00 a 0% a a a 16 0.00 0.00 0.00 12.00 a 0% 0 a a 17 0.00 0.00 0.00 12.00 0 0% 0 0 a 18 0.00 0.00 0.00 12.00 0 0% 0 0 0 19 0.00 0.00 0.00 12.00 a 0% a a 0 20 0.00 0.00 0.00 12.00 a 0% 0 a 0 21 0.00 0.00 000 12.00 0 0% 0 0 0 22 0.00 0.00 0.00 12.00 0 0% 0 0 0 23 0.00 0.00 0.00 12.00 a 0% a a 0 24 0.00 0.00 0.00 12.00 0 0% a 0 0 25 0.00 000 0.00 12.00 0 0% 0 0 0 26 0.00 0.00 0.00 12.00 a 0% a 0 0 27 0.00 0.00 0.00 12.00 0 0% 0 0 0 28 0.00 0.00 0.00 12.00 0 0% 0 0 0 29 0.00 0.00 0.00 12.00 0 0% 0 0 0 30 0.00 0.00 0.00 12.00 0 0% 0 0 0 31 0.00 0.00 0.00 12.00 0 0% 0 0 0

SUBTOTALS = 0.00 I I $0 I I $0 $0 $0

THE FOLLOWING BOXES IN COLUMN "D" BELOW MAY BE USED TO

CALCULATE THE ADJUSTED BASE SALARY, AS INDICATED:

(Use of these cells will affect all of the adjusted base salary column; if individual anniversary dates differ, the adjusted base salaries must be entered individually in C()llJmn "0" of the spreadsheet and explained in the budget justification)

NUMBER OF HOURS FOR FULL TIME EQUIVALENT: 1 0 --I

ANNUAL INCREASE FACTOR: 0.00%

ANNUAL INCREASE DATE: I 00/00/00

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE I 0

"Adjust the number of months per period as recommended in the RFP.

SUMMARY OF MATERIALS AND SUPPLIES

** RFP No.

ITEM

TOTAL::

Period I Unit Unit Price Quantity

$0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

Period II Unit Unit

Subtotal Price Quantity Subtotal $0.00 $0.00 0 $0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

, $0.00

$0.00

Period III Period IV Unit Unit Unit Unit Price Quantity Subtotal Price Quantity

$0.00 0 $0.00 $0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

. 0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

0.00 0 0.00 0.00 0

$0.00

Please use current catalog, historical documentation, or vendor quotes.

Supporting documentation may be requested at a later date.

.... RFP No.

ITEM Subtotal 1 $0,00 2 0.00 3 0.00 4 0,00 5 0.00 6 0.00 7 0,00 8 0.00 9 0,00

10 0.00 11 0.00 12 0.00 13 0.00 14 0.00 15 0.00 16 0.00 17 0.00 18 0.00 19 0.00 20 0.00 21 0.00 22 0.00 23 0.00 24 0.00 25 0.00 26 0.00 27 0.00 28 0.00 29 0.00 30 0.00

TOTAL = $0.00

Please use current catalog, historic documentation, or vendor quotes, Supporting documentation may be

ITEM

TOTAL =

Period V Unit Unit

Price Quantity $0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0 0,00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0 0,00 0

0.00 0

0.00 0

0.00 0 0,00 0

0.00 0

0.00 0

0.00 0 0,00 0

0.00 0 0,00 0

0.00 0

0.00 0

0.00 0

0.00 0

0.00 0

Period VI Unit Unit

Subtotal Price Quantity Subtotal $0.00 $0.00 0 $0.00

0.00 0,00 0 0.00

0.00 0.00 0 0.00

0.00 0,00 0 0,00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0,00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0,00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00 0,00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0,00

0.00 0.00 0 0.00

0.00 0,00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0.00 0 0.00

0.00 0,00 0 0.00

$0.00 $0.00

Period VII Unit Unit Price Quantity Subtotal TOTAL

$0,00 0 $0.00 $0.00

0.00 0 0.00 0,00

0.00 0 0.00 0.00 0,00 0 0.00 0,00

0.00 0 0.00 0,00 0,00 0 0.00 0.00

0.00 0 0.00 0,00

0.00 0 0,00 0.00

0.00 0 0.00 0.00

0.00 0 0,00 0.00 0,00 0 0,00 0.00

0.00 0 0.00 0.00

0.00 0 0,00 0,00

0.00 0 0.00 0.00

0.00 0 0.00 0,00

0.00 0 0.00 0,00

0.00 0…