Attachment-11-LTRC_CC_Cost_Proposal_Template_Amendment_001.xlsx

XLSX spreadsheet 99 KB Posted

Attached to
Title Lung Tissue Research Consortium - Clinical Center Federal contract opportunity
Solicitation number
NHLBI-HR-16-07
Issued by
Department of Health and Human Services National Institutes of Health

About this file

Attachment 11 - Cost Proposal Template

View the file

Other files for this federal contract opportunity

Other files attached to Title Lung Tissue Research Consortium - Clinical Center, newest first.
File Type Posted
LTRC_CC_Amendment_002.pdf PDF
LTRC_CC_Amendment_001.pdf PDF
Attachment-1-LTRC-CC_Additional_Information.pdf PDF
Attachment-2-Clinical_Centers_Past_Performance_Questionnaire.pdf PDF
RFP_Cvr_Ltr.pdf PDF
Attachment-3-NIH-Reps-and-Certs.pdf PDF
NHLBI-_HR-16-07-_RFP.pdf PDF

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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 review/award 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 rate/salary for each proposed (named) individuals. Acceptable documentation includes any one 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/IdCSubmission.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.

CPI

LTRC CLINICAL CENTER

Weighted Average Inflation Rate
For the Contract Period

Performance Period: 12/16/15 thru 12/15/18

(2)(3)
(1)Est.# of Months(2) x (3)
PeriodCPIApplicable
12/16/15To12/31/151.60%0.50.80%2015
1/1/16To12/31/161.60%12.019.20%2016
1/1/17To12/31/171.90%12.022.80%2017
1/1/18To12/31/182.00%11.523.00%2018
1/1/19To12/15/191.90%- 00.00%2019
36.065.80%

36.0 into 65.80% = 1.80%

SUMMARY

SUMMARY OF PROPOSED COSTS
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
LTRC CLINICAL CENTER
Task Area AYEAR 2YEAR 3
COREPROTOCOLCOREPROTOCOLCOREPROTOCOLTOTALTOTALTOTAL
12/16/2015 - 12/15/201612/16/2016 - 12/15/201712/16/2017 - 12/15/2018COREPROTOCOLCORE &
PROTOCL
CORE
DIRECT LABOR$ -$ -$ -$ -$ -
FRINGE BENEFITS$ -$ -$ -$ -$ -
TOTAL DIRECT LABOR$ -$ -$ -$ -$ -
MATERIAL AND SUPPLIES$ -$ -$ -$ -$ -
TRAVEL$ -$ -$ -$ -$ -
OTHER DIRECT COSTS$ -$ -$ -$ -$ -
SUBCONTRACTS$ -$ -$ -$ -$ -
PROTOCOL
Characterization Costs$ -$ -$ -$ -$ -
Tissue Costs$ -$ -$ -$ -$ -
CT Costs$ -$ -$ -$ -$ -

TOTAL DIRECT COSTS $ - $ - $ - $ - $ - $ - $ - $ - $ -

IDC EXCLUSIONS$ -$ -$ -$ -$ -$ -$ -$ -$ -
IDC BASE$ -$ -$ -$ -$ -$ -$ -$ -$ -
INDIRECT COSTS0.0%$ -$ -0.0%$ -$ -0.0%$ -$ -$ -$ -$ -

TOTAL COSTS $ - $ - $ - $ - $ - $ - $ - $ - $ -

TOTAL CORE & PROTOCOL $0 $0 $0 $0 $ -

Note:
Indirect costs are included in the capitation rate and are therefore not reflected above under Protocol.

Attachment 11

Not all organizations allocate indirect cost in the same way. It is important that you 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 Companies 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.

If you have questions regarding indirect (F&A) rates see website: http://oamp.od.nih.gov/dfas/IdCSubmission.asp This website also contains definitions, examples, and training.

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

Labor - Core

SUMMARY OF DIRECT LABOR (CORE)
AND FRINGE BENEFITS
PERCENT OF EFFORT
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
YEAR 1YEAR 2YEAR 3
12/16/15Through12/15/1612/16/16Through12/16/1712/17/17Through12/16/18TOTALTOTAL
CURRENTADJUSTEDPERCENTNUMBERSALARYFRINGEFRINGEPERCENTNUMBERSALARYFRINGEFRINGEPERCENTNUMBERSALARYFRINGEFRINGESALARYFRINGE
EMPLOYEEPOSITIONBASE SALBASE SALEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTEFFORTMONTHSCOSTRATECOSTCOSTCOST
1Principal Investigator$010%12.00$00.0%$010%12.00$ - 00.0%$010%12.00$ - 00.0%$0$ - 0$ - 0
2Co-Investigator$05%12.00$00.0%05%12.00$ - 00.0%05%12.00$ - 00.0%0$ - 0$ - 0
3Clinical Coordinator$020%12.00$00.0%020%12.00$ - 00.0%020%12.00$ - 00.0%0$ - 0$ - 0
4Tissue Tech.$020%12.00$00.0%020%12.00$ - 00.0%020%12.00$ - 00.0%0$ - 0$ - 0

SUBTOTALS = 55% $0 $0 55% $ - 0 $0 55% $ - 0 $0 $ - 0 $ - 0

ANNUAL INCREASE FACTOR: 0.00%

ANNUAL INCREASE DATE: 00/00/00

NUMBER OF MONTHS AT NEXT ANNUAL INCREASE 0

CORE LABOR

&D &F

Insert annual cost of living % and/or merit increases as applicable and explain the % in the budget justification.

Insert annual increase date.

Insert number of months at the the new hourly rate.

Materials

SUMMARY OF MATERIALS AND SUPPLIES (CORE)
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
Period IPeriod IIPeriod IIIPeriod IV
UnitUnitUnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.000.0000.00$0.00
30.0000.000.0000.000.0000.000.0000.00$0.00
40.0000.000.0000.000.0000.000.0000.00$0.00
50.0000.000.0000.000.0000.000.0000.00$0.00
60.0000.000.0000.000.0000.000.0000.00$0.00
70.0000.000.0000.000.0000.000.0000.00$0.00
80.0000.000.0000.000.0000.000.0000.00$0.00
90.0000.000.0000.000.0000.000.0000.00$0.00
100.0000.000.0000.000.0000.000.0000.00$0.00
110.0000.000.0000.000.0000.000.0000.00$0.00
120.0000.000.0000.000.0000.000.0000.00$0.00
130.0000.000.0000.000.0000.000.0000.00$0.00
140.0000.000.0000.000.0000.000.0000.00$0.00
150.0000.000.0000.000.0000.000.0000.00$0.00
160.0000.000.0000.000.0000.000.0000.00$0.00
170.0000.000.0000.000.0000.000.0000.00$0.00
180.0000.000.0000.000.0000.000.0000.00$0.00
190.0000.000.0000.000.0000.000.0000.00$0.00
200.0000.000.0000.000.0000.000.0000.00$0.00
210.0000.000.0000.000.0000.000.0000.00$0.00
220.0000.000.0000.000.0000.000.0000.00$0.00
230.0000.000.0000.000.0000.000.0000.00$0.00
240.0000.000.0000.000.0000.000.0000.00$0.00
250.0000.000.0000.000.0000.000.0000.00$0.00
260.0000.000.0000.000.0000.000.0000.00$0.00
270.0000.000.0000.000.0000.000.0000.00$0.00
280.0000.000.0000.000.0000.000.0000.00$0.00
290.0000.000.0000.000.0000.000.0000.00$0.00
300.0000.000.0000.000.0000.000.0000.00$0.00
TOTAL =$0.00$0.00$0.00$0.00$0.00

Please use current catalog prices, or vendor quotes. Supporting documentation may be requested at a later date.

Travel

SUMMARY OF TRAVEL (CORE)
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
TRAVELYear 1Year 2Year 3
RateTotals
A. STEERING COMMITTEE1.0181.0181.018
Bethesda, MD
Average RT airfare to Bethesda, MD- 0- 0- 0
Per Diem (1 days)- 0- 0- 0
Ground Transp./Miscellaneous- 0- 0- 0
Total Trip Cost- 0- 0- 0
No. of Trips Per Year311
No. Persons Traveling333
Yearly Travel Costs- 0- 0- 0- 0

ODC

SUMMARY OF OTHER DIRECT COSTS (CORE)
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
Period IPeriod IIPeriod III
UnitUnitUnitUnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1$0.000$0.00$0.000$0.00$0.000$0.00$0.00
20.0000.000.0000.000.0000.00$0.00
30.0000.000.0000.000.0000.00$0.00
40.0000.000.0000.000.0000.00$0.00
50.0000.000.0000.000.0000.00$0.00
60.0000.000.0000.000.0000.00$0.00
70.0000.000.0000.000.0000.00$0.00
80.0000.000.0000.000.0000.00$0.00
90.0000.000.0000.000.0000.00$0.00
100.0000.000.0000.000.0000.00$0.00
110.0000.000.0000.000.0000.00$0.00
120.0000.000.0000.000.0000.00$0.00
130.0000.000.0000.000.0000.00$0.00
140.0000.000.0000.000.0000.00$0.00
150.0000.000.0000.000.0000.00$0.00
160.0000.000.0000.000.0000.00$0.00
170.0000.000.0000.000.0000.00$0.00
180.0000.000.0000.000.0000.00$0.00
190.0000.000.0000.000.0000.00$0.00
200.0000.000.0000.000.0000.00$0.00
210.0000.000.0000.000.0000.00$0.00
220.0000.000.0000.000.0000.00$0.00
230.0000.000.0000.000.0000.00$0.00
240.0000.000.0000.000.0000.00$0.00
250.0000.000.0000.000.0000.00$0.00
260.0000.000.0000.000.0000.00$0.00
270.0000.000.0000.000.0000.00$0.00
280.0000.000.0000.000.0000.00$0.00
290.0000.000.0000.000.0000.00$0.00
300.0000.000.0000.000.0000.00$0.00
TOTAL =$0.00$0.00$0.00$0.00

Please use current catalog prices, or vendor quotes. Supporting documentation may be requested at a later date.

Subcontract

SUMMARY OF SUBCONTRACTOR COSTS (CORE)
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
SUBCONTRACT #Period IPeriod IIPeriod IIITOTAL
(1)$0$0$0$0
(2)0000
(3)0000
(4)0000
(5)0000
(6)0000
(7)0000
(8)0000
(9)0000
(10)0000
TOTAL =$0$0$0$0

A complete breakdown and summary sheet for each proposed subcontract must be included with the prime proposal. The same format should be used for both the prime and subcontract proposals.

Characterization

SUMMARY OF CAPITATION - ENROLLMENT AND CHARACTERIZATION
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
LABORYEAR 1YEAR 2YEAR 3YEAR 4
ADJUSTEDPERCENTSALARYFRINGEFRINGE12/16/1512/16/1612/16/17
EMPLOYEEPOSITIONBASE SALEFFORTCOSTRATECOST12/15/1612/15/1712/15/18TOTAL
Enter Inflation Factor000
1Principal Investigator$ -3%$ -0.0%$ -$ -$ -$ -$ -$ -
2Co-Investigator$ -0%$ -0.0%$ -$ -$ -$ -$ -$ -
3Clinical Coordinator$ -15%$ -0.0%$ -$ -$ -$ -$ -$ -
4Radiology Tech$ -15%$ -0.0%$ -$ -$ -$ -$ -$ -
5Data Entry/Admin.$ -15%$ -0.0%$ -$ -$ -$ -$ -$ -
$ -$ -0.0%$ -$ -$ -$ -$ -$ -

SUBTOTALS 48% $ - $ - $ - $ - $ - $ - $ -

OTHER DIRECT COSTS12/16/1512/16/1612/16/17
UnitUnit12/15/16UnitUnit12/15/17UnitUnit12/15/18UnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTotal
1.0181.0181.018
Shipping:
1FedEx 10 lbs. box$ - 033$ - 0$ - 033$ - 0$ - 033$ - 0$ - 00.00$ - 0
2Dry Ice 5 lbs.$ - 033$ - 0$ - 033$ - 0$ - 033$ - 0$ - 00.00$ - 0

SUBTOTAL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0

PATIENT CARE12/16/1512/16/1612/16/17
UnitUnit12/15/16UnitUnit12/15/17UnitUnit12/15/18UnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTotal
1.0181.018- 0
1PFT with DLCO$ - 033$ -$ - 033$ -$ - 033$ -$ - 00$ -$ -
2Blood Draw$ - 033$ -$ - 033$ -$ - 033$ -$ - 00$ -$ -
3Six Minute Walk$ - 033$ -$ - 033$ -$ - 033$ -$ - 00$ -$ -
Blood Tests3333330
4CBC$ - 033$ -$ - 033$ -$ - 033$ -$ - 00$ -$ -
5Rheumatoid Factor (RF)$ - 017$ -$ - 017$ -$ - 017$ -$ - 00$ -$ -
6Creatine Kinase (CK)$ - 017$ -$ - 017$ -$ - 017$ -$ - 00$ -$ -
7Erythrocyte Sedimentation Rate (ESR)$ - 017$ -$ - 017$ -$ - 017$ -$ - 00$ -$ -
8Anti-Nuclear Antibody (ANA)$ - 017$ -$ - 017$ -$ - 017$ -$ - 00$ -$ -
9Antibodies to double standard DNA (Anti-dsDNA)$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
10Jo-1 Antigen$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
11Antibodies to SCL-70$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
12Antibodies to SS-A$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
13Antibodies to SS-B$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
14Anti-centromene Antibodies$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
15Extractable Nuclear Antigen (ENA)$ - 03$ -$ - 03$ -$ - 03$ -$ - 00$ -$ -
16Alpha-1 Antitrysin Level$ - 017$ -$ - 017$ -$ - 017$ -$ - 00$ -$ -

SUBTOTAL $ - $ - $ - $ - $ -

YEAR 1YEAR 2YEAR 3Total
SUBTOTALS$ -$ -$ -$ -$ -
IDC EXCLUSIONS$ -$ -$ -$ -$ -
IDC BASE$ -$ -$ -$ -$ -
INDIRECT COSTS0.00%$ -0.00%$ -0.00%$ -0.00%$ -$ -

TOTALS $ - $ - $ - $ - $ -

Capitation Rate Characterization$ -$ -$ -$ -
Note: Capitation rates based on 33 enrollments per year.

Tissue

SUMMARY OF CAPITATION - TISSUE PROCUREMENT AND PROCESSING
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07
LABORYEAR 1YEAR 2YEAR 3
ADJUSTEDPERCENTSALARYFRINGEFRINGE12/16/1512/16/1612/16/17
EMPLOYEEPOSITIONBASE SALEFFORTCOSTRATECOST12/15/1612/15/1712/15/18TOTAL
Enter Escalation Factor000
1Lab Tech/Tissue$ -15%$ -0.0%$ -$ -$ -$ -$ -$ -
2$ -$ -0.0%$ -$ -$ -$ -$ -$ -

SUBTOTALS 15% $ - $ - $ - $ - $ - $ - $ -

MATERIALS & SUPPLIESYEAR 1YEAR 2YEAR 3
12/16/1512/16/1612/16/17
UnitUnit12/15/16UnitUnit12/15/17UnitUnit12/15/18UnitUnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTotalQuantitySubtotal
1.0181.0181.018
1Laboratory supplies$ - 00$ - 0$ - 00$ - 0$ - 00$ - 0$ - 00$ - 0$ - 00$0.00

SUBTOTAL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0

YEAR 1YEAR 2YEAR 3
OTHER DIRECT COSTS12/16/1512/16/1612/16/17
UnitUnit12/15/16UnitUnit12/15/17UnitUnit12/15/18UnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTotal
Shipping1.0181.0181.018
1FedEx 10 lbs. box$ - 00$ - 0$ - 00$ - 0$ - 00$ - 0$ - 00$ -$ - 0
2Dry Ice 5 lbs.$ - 00$ - 0$ - 00$ - 0$ - 00$ - 0$ - 00$ -$ - 0

SUBTOTAL $ - 0 $ - 0 $ - 0 $ - $ - 0

YEAR 1YEAR 2YEAR 3Total
12/16/1512/16/1612/16/17
12/15/1612/15/1712/15/18
SUBTOTALS$ -$ -$ -$ -$ -
IDC EXCLUSIONS$ -$ -$ -$ -$ -
IDC BASE$ -$ -$ -$ -$ -
INDIRECT COSTS0.00%$ -0.00%$ -0.00%$ -0.00%$ -$ -

TOTALS $ - $ - $ - $ - $ -

Capitation Rate Tissue$ -$ -$ -$ -
Note: Capitation rates based on 33 tissues per year.

CT

SUMMARY OF CAPITATION - CT SCAN AND CARDIOPULMONARY EXERCISE TESTING
** Enter Contractor's Name
RFP No. NHLBI-HR-16-07

CAPITATION -- CT SCAN

PATIENT CARE12/16/1512/16/1612/16/17
UnitUnit12/15/16UnitUnit12/15/17UnitUnit12/15/18UnitUnit
ITEMPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalPriceQuantitySubtotalTOTAL
1.0181.0181.018
1Chest CT scan$ - 033$ -$ - 033$ -$ - 033$ -$ - 033$ -$ -

TOTAL $ - $ - $ - $ - $ -

Capitation Rate CT$ -$ -$ -$ -
Note: Capitation rates based on 33 per year.

File details come from the government source that posted it. Updated .