Attachment_2_-_Pricing_Sheet.doc

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Designated Provider/US Family Health Plan - Data Support
Solicitation number
HT0011-13-R-0001
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Attachment 2 - Pricing Sheet

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ITEM NO

SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Transition-In - Labor

FFP

FOB: Destination

NET AMT

Attachment 2 - PRICING SHEET

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Transition-In - Travel

COST

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Transition-In - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Base Year - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Base Year - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Base Year - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 1 - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 1 - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 1 - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 2 - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 2 - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 2 - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 3 - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 3 - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12
Months
OPTION
Option 3 - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months
OPTION
Option 4 - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months
OPTION
Option 4 - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months

Option 4 - ODCs

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months
OPTION
Tansition Out - Labor

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months
OPTION
Transition Out - Travel

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
6
Months
OPTION
Transition Out - ODCs

NET AMT

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