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Instructions
| Instructions to Offerors: | |
| 1. | This pricing spreadsheet includes all initial requirements that will be issued as lots under task orders after contract award. |
| 2. | The offeror shall fill out each Lot tab in its entirety. Blue boxes designate those fields into which the offeror can enter values/information. |
| 3. | The offeror shall provide the proposed hours and monthly price for each requirement. Proposed hours are requested for evaluation purposes only to assess the level of effort. Please note that historically the level of effort for one Full Time worker is 1920 hours per year. |
| 4. | A level of effort to include labor category and number of workers that have historically been successful in fulfilling the requirements is provided. |
| 5. | If a different level of effort is proposed, either labor category or number of workers, please provide an explanation demonstrating how the different level of effort will be successful. The text block titled Level of Effort shall be used only for providing the explanation for a different level of effort as described in 4. above. No other information provided in this block will be evaluated. |
| 6. | Billing will occur on a monthly basis, therefore the total price will be equally distributed among each of the 12 months and the task order will list months as a unit of issue. |
| 7. | Any required travel will be reimbursed in the amount of actual expenses in accordance with the contract and the Joint Travel Regulations. A price shall not be proposed for travel. |
Lot A Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0001 | The contractor shall provide administrative support services to perform the Other Health Insurance (OHI) discovery function for the Naval Health Clinic, Patuxent River, MD and the Branch Medical Clinics at Indian Head, MD and Dahlgren, VA in accordance with the PWS contained in this RFQ. | | | | |
Base Period: 1 October 2017 – 30 September 2018
| | 12 | Months | $0.00 |
| 1001 | The contractor shall provide administrative support services to perform the Other Health Insurance (OHI) discovery function for the Naval Health Clinic, Patuxent River, MD and the Branch Medical Clinics at Indian Head, MD and Dahlgren, VA in accordance with the PWS contained in this RFQ. | | | |
Option Period: 1 October 2018 – 30 September 2019
| | 12 | Months | $0.00 |
| 2001 | The contractor shall provide administrative support services to perform the Other Health Insurance (OHI) discovery function for the Naval Health Clinic, Patuxent River, MD and the Branch Medical Clinics at Indian Head, MD and Dahlgren, VA in accordance with the PWS contained in this RFQ. | | | |
Option Period: 1 October 2019 – 30 September 2020
| | 12 | Months | $0.00 |
| 3001 | The contractor shall provide administrative support services to perform the Other Health Insurance (OHI) discovery function for the Naval Health Clinic, Patuxent River, MD and the Branch Medical Clinics at Indian Head, MD and Dahlgren, VA in accordance with the PWS contained in this RFQ. | | | |
Option Period: 1 October 2020 – 30 September 2021
| | 12 | Months | $0.00 |
| 4001 | The contractor shall provide administrative support services to perform the Other Health Insurance (OHI) discovery function for the Naval Health Clinic, Patuxent River, MD and the Branch Medical Clinics at Indian Head, MD and Dahlgren, VA in accordance with the PWS contained in this RFQ. | | | |
Option Period: 1 October 2021 – 30 September 2022
| 12 | Months | | $0.00 | |
| | Total Price for CLIN 0001 and all Options: | | $0.00 |
| Historical Data: | |
| Historical Labor Category: | General Clerk II |
| Historical Level of Effort: | 1 FTE |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0001 | | | | $0.00 |
| 1001 | | | | $0.00 |
| 2001 | | | | $0.00 |
| 3001 | | | | $0.00 |
| 4001 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot B Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0002 | The contractor shall provide administrative support services for the Medical Home Port (MHP) program located at the Naval Health Clinic Cherry Point, NC in accordance with the PWS contained in this RFQ. | | | | |
POP: 1 October 2017 – 30 September 2018
| | 12 | Months | $0.00 |
| 1002 | The contractor shall provide administrative support services for the Medical Home Port (MHP) program located at the Naval Health Clinic Cherry Point, NC in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2002 | The contractor shall provide administrative support services for the Medical Home Port (MHP) program located at the Naval Health Clinic Cherry Point, NC in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3002 | The contractor shall provide administrative support services for the Medical Home Port (MHP) program located at the Naval Health Clinic Cherry Point, NC in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4002 | The contractor shall provide administrative support services for the Medical Home Port (MHP) program located at the Naval Health Clinic Cherry Point, NC in accordance with the PWS contained in this RFQ. | | | |
| 12 | Months | | $0.00 | |
| | Total Price for CLIN 0002 and all Options: | | $0.00 |
| Historical Data: | |
| Historical Labor Category: | General Clerk II |
| Historical Level of Effort: | 1 FTE |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0002 | | | | $0.00 |
| 1002 | | | | $0.00 |
| 2002 | | | | $0.00 |
| 3002 | | | | $0.00 |
| 4002 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot C Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0003 | The contractor shall provide Medical Records Clerk functions in support of Naval Health Clinic Hawaii’s mission in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1003 | The contractor shall provide Medical Records Clerk functions in support of Naval Health Clinic Hawaii’s mission in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2003 | The contractor shall provide Medical Records Clerk functions in support of Naval Health Clinic Hawaii’s mission in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3003 | The contractor shall provide Medical Records Clerk functions in support of Naval Health Clinic Hawaii’s mission in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4003 | The contractor shall provide Medical Records Clerk functions in support of Naval Health Clinic Hawaii’s mission in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0003 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | Medical Record Clerk | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0003 | | | | $0.00 |
| 1003 | | | | $0.00 |
| 2003 | | | | $0.00 |
| 3003 | | | | $0.00 |
| 4003 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot D Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0004 | The contractor shall provide medical administrative support services (Active Duty Dental Plan (ADDP) Clerk) at one of the Naval Medical Center Portsmouth, Virginia Branch Health Clinics in a dental department with the currently assigned location at Branch Health Clinic Naval Station Norfolk, Virginia in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1004 | The contractor shall provide medical administrative support services (Active Duty Dental Plan (ADDP) Clerk) at one of the Naval Medical Center Portsmouth, Virginia Branch Health Clinics in a dental department with the currently assigned location at Branch Health Clinic Naval Station Norfolk, Virginia in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2004 | The contractor shall provide medical administrative support services (Active Duty Dental Plan (ADDP) Clerk) at one of the Naval Medical Center Portsmouth, Virginia Branch Health Clinics in a dental department with the currently assigned location at Branch Health Clinic Naval Station Norfolk, Virginia in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3004 | The contractor shall provide medical administrative support services (Active Duty Dental Plan (ADDP) Clerk) at one of the Naval Medical Center Portsmouth, Virginia Branch Health Clinics in a dental department with the currently assigned location at Branch Health Clinic Naval Station Norfolk, Virginia in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4004 | The contractor shall provide medical administrative support services (Active Duty Dental Plan (ADDP) Clerk) at one of the Naval Medical Center Portsmouth, Virginia Branch Health Clinics in a dental department with the currently assigned location at Branch Health Clinic Naval Station Norfolk, Virginia in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0004 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | General Clerk II | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0004 | | | | $0.00 |
| 1004 | | | | $0.00 |
| 2004 | | | | $0.00 |
| 3004 | | | | $0.00 |
| 4004 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot E Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0005 | The contractor shall provide medical administrative support services to the Dental Department under Naval Health Clinic Quantico, VA in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1005 | The contractor shall provide medical administrative support services to the Dental Department under Naval Health Clinic Quantico, VA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2005 | The contractor shall provide medical administrative support services to the Dental Department under Naval Health Clinic Quantico, VA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3005 | The contractor shall provide medical administrative support services to the Dental Department under Naval Health Clinic Quantico, VA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4005 | The contractor shall provide medical administrative support services to the Dental Department under Naval Health Clinic Quantico, VA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0005 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | General Clerk II | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0005 | | | | $0.00 |
| 1005 | | | | $0.00 |
| 2005 | | | | $0.00 |
| 3005 | | | | $0.00 |
| 4005 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot F Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0006 | The contractor shall provide Clear and Legible Reporting services for the Naval Hospital Jacksonville, FL in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1006 | The contractor shall provide Clear and Legible Reporting services for the Naval Hospital Jacksonville, FL in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2006 | The contractor shall provide Clear and Legible Reporting services for the Naval Hospital Jacksonville, FL in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3006 | The contractor shall provide Clear and Legible Reporting services for the Naval Hospital Jacksonville, FL in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4006 | The contractor shall provide Clear and Legible Reporting services for the Naval Hospital Jacksonville, FL in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0006 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | General Clerk II | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0006 | | | | $0.00 |
| 1006 | | | | $0.00 |
| 2006 | | | | $0.00 |
| 3006 | | | | $0.00 |
| 4006 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot G Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0007 | The contractor shall provide administrative support services for the Naval Hospital Twenty-nine Palms, CA in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1007 | The contractor shall provide administrative support services for the Naval Hospital Twenty-nine Palms, CA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2007 | The contractor shall provide administrative support services for the Naval Hospital Twenty-nine Palms, CA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3007 | The contractor shall provide administrative support services for the Naval Hospital Twenty-nine Palms, CA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4007 | The contractor shall provide administrative support services for the Naval Hospital Twenty-nine Palms, CA in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0007 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | General Clerk I | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0007 | | | | $0.00 |
| 1007 | | | | $0.00 |
| 2007 | | | | $0.00 |
| 3007 | | | | $0.00 |
| 4007 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Lot H Enter the proposed (monthly) UNIT PRICE in the table below. The contractor will be paid a fixed monthly price for the services provided. Services will not be paid on a “Labor Hour” or “Time and Materials” basis.
| CLIN | Required Services | Quantity | Unit | Unit Price | Amount |
| 0008 | The contractor shall provide medical board liaison services for the Naval Health Clinic Hawaii in accordance with the PWS contained in this RFQ. | | | | |
| | 12 | Months | $0.00 |
| 1008 | The contractor shall provide medical board liaison services for the Naval Health Clinic Hawaii in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 2008 | The contractor shall provide medical board liaison services for the Naval Health Clinic Hawaii in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 3008 | The contractor shall provide medical board liaison services for the Naval Health Clinic Hawaii in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | $0.00 |
| 4008 | The contractor shall provide medical board liaison services for the Naval Health Clinic Hawaii in accordance with the PWS contained in this RFQ. | | | |
| | 12 | Months | | $0.00 | |
| | | | Total Price for CLIN 0008 and all Options: | | $0.00 |
| Historical Data: | | | | | | |
| Historical Labor Category: | General Clerk II | | | | | |
| Historical Level of Effort: | 1 FTE | | | | | |
| Provide Pricing Breakdown (See Note 3 on Instructions Tab) |
| Provide a breakdown of the proposed price. The table below shall be used. Choose the Labor Category from the drop-down menu that will be used. |
The "AMOUNT" in the above table shall equal the "AMOUNT" in the below table.
| CLIN | Labor Category | Proposed Hours | Hourly Unit Price | Amount |
| 0008 | | | | $0.00 |
| 1008 | | | | $0.00 |
| 2008 | | | | $0.00 |
| 3008 | | | | $0.00 |
| 4008 | | | | $0.00 |
| LEVEL OF EFFORT EXPLANATION: Use this section to explain any proposed any proposed level of effort that differs from historical data/level of effort provided. | | | | |
Sheet1
| Accounting Clerk I |
| Accounting Clerk II |
| Accounting Clerk III |
| General Clerk I |
| General Clerk II |
| General Clerk III |
| Medical Record Clerk |
| Medical Record Technician |
Summary Page
| Medically Related Administrative and Programmatic Support Services MATO Total Price Summary | |
| Lot | Total Lot Price |
| A | $0.00 |
| B | $0.00 |
| C | $0.00 |
| D | $0.00 |
| E | $0.00 |
| F | $0.00 |
| G | $0.00 |
| H | $0.00 |
Total Price for All Lots $0.00