J.42 CLIN 0009 Cost Proposal Template - Outgoing Contractor Workload Transition Activites.xlsx
XLSX spreadsheet 23 KB Posted
- Solicitation number
- 75FCMC20R0008
About this file
This document provides templates for a cost proposal related to a solicitation for Medicare Administrative Contractor services. The templates require cost and pricing information for a CLIN to cover outgoing contractor workload transition activities during the closeout period. Data is to be provided for direct labor hours and rates by category, fringe benefits, travel, subcontractors, other direct costs, indirect costs, fees, and complementary credits. A separate attachment requests a travel cost summary with details on trip purpose, origin, destination, number of travelers, trips, days, lodging rates and costs, per diem, airfare, car rental, mileage and total costs. The solicitation is for a Part A and Part B Medicare Administrative Contractor to provide specified health insurance benefit administration services including Medicare claims processing and payment for Jurisdiction L which covers Delaware, Maryland, New Jersey, Pennsylvania, Washington D.C., and parts of Virginia.
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Text version
CLIN-0009
| COST TEMPLATE - Attachment J.42 | |||||||||
| (Provide a cost spreadsheet for each CLIN proposed) | |||||||||
| CLIN 0009 - Outgoing Contractor Workload Transition Activities (Closeout) | C.5.2 | I | |||||||
| A/B SERVICES | Total FTEs | Workload Closeout Project Plan | 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 | $0.00 | $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
TOTAL ALL DIRECT COSTS $0 $0.00
Indirect Costs (at ______ %) $0 $0.00
TOTAL OTHER BEFORE FEE $0 $0.00
| Base Fee (at ____%) | $0 | $0.00 | |
| Award Fee (at ______%) | $0 | $0.00 | |
| Fixed Fee (at ______%) | $0 | $0.00 |
TOTAL OTHER AFTER FEE $0 $0 $0.00
| Complementary Credits | |||
| Note: comp. credit information will be provided by CMS prior to final proposal revision. Offerors should not propose amounts at this time. | |||
| GRAND TOTAL | $0 | $0 | $0.00 |
20180208
&"Arial,Bold"&12 75FCMC20R0008
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
Confidential Procurement Sensitive &P
ODC Schedule
| ODC SCHEDULE - Attachment J.42 | |
| (Provide an ODC Spreadsheet for each CLIN Proposed) | |
| CLIN 0009 A/B SERVICES | |
| Cost Element | TOTAL |
Add costs by category
TOTAL ODCs $0.00
&"Arial,Bold"&12 75FCMC20R0008
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
TRAVEL
| Attachment J.42 |
| TRAVEL SUMMARY |
| CLIN 0009 |
| 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"&12 75FCMC20R0008
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&P
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