MDH BHA - EXHIBIT B - Statewide Training for Mobile Crisis Teams.xlsx
XLSX spreadsheet 20 KB Posted
- Attached to
- Statewide Training for Mobile Crisis Teams and Behavioral Health Crisis Stabilization Centers
- Solicitation number
- BPM044260
- Issued by
- Maryland
About this file
This document is the Exhibit B - Financial Proposal Form for a Request for Applications (RFA) issued by the Maryland Department of Health (MDH) Behavioral Health Administration (BHA) to establish, administer, and evaluate a statewide training program for Mobile Crisis Teams (MCT) and Behavioral Health Crisis Stabilization Centers (BHCSC). The RFA seeks to train MCT and BHCSC staff on various topics as outlined in the Scope of Work. The project term is for multiple fiscal years, and the Financial Proposal Form includes line items for salaries, fringe benefits, equipment and supplies, travel, and other direct costs. The proposal requires a Budget Narrative to accompany the Financial Proposal Form.
The Financial Proposal Form provides a format for offerors to submit all price information, including for any option years. Offerors must adhere to the instructions provided and ensure that no items are amended, altered, or left blank, as this may result in the proposal being deemed non-responsive. The indirect cost percentage must be selected from a dropdown, and the Total Costs, including direct and indirect, must be provided.
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Text version
Sheet1
| Exhibit B - Financial Proposal Form |
| The Financial Proposal shall contain all price information in the format specified on these pages. Complete the Financial Proposal Form only as provided in the Financial Proposal Form format. Do not amend, alter or leave blank any items on the Financial Proposal Form. If option years are included, Offerors must submit costs for each option year. Failure to adhere to any of these instructions may result in the financial proposal being determined non- responsive and rejected by the Department. |
| Please Note: Budget Narrative (to be completed in Word) must accompany each Financial Proposal Form. The Budget Narrative shall contain all price information in the format specified on the Financial Proposal Form. |
Sydnee Distance: Sydnee Distance:
Please be sure to submit the Budget Narrative (in Word) as well.
| Maryland Department of Health Behavioral Health Administration |
| Project Title |
Sydnee Distance: Sydnee Distance:
Please insert the Project Name.
| Project Term | |||||||
| Service Description | FY 22 | FY 23 | FY 23 | Total Price | |||
| Salaries | FY | ||||||
| Personnel (Please include Name, Title, and Percentage of Time Allotted to this Project) | |||||||
| Name | Title | % Effort | Annual Salary | ||||
| $ - 0 |
| COST: | $ - 0 |
| Fringe Benefits |
| COST: | $ - 0 |
| Equipment & Supplies |
| COST: | $ - 0 |
| Travel |
| COST: | $ - 0 |
| Other Direct Costs |
| COST: | $ - 0 |
| TOTAL COST | |
| TOTAL DIRECT COSTS | $ - 0 |
| TOTAL INDIRECT COSTS - IDC |
Aaron Jenkins: Aaron Jenkins:
| Please select the indirect cost percentage.from the drop down | % | $ - 0 | ||
| TOTAL COSTS - DIRECT + INDIRECT | $ - 0 | |||
| Prices Attested To By: |
Signature
| Printed Name & Title |
| Company Name |
| Company Address |
| Location(s) from which services will be performed (City, State) |
| Telephone |
| Fax |
| FEIN |
| eMMA# |
| Please Note: Budget Narrative (to be completed in Word) must accompany each Financial Proposal Form. |
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