J-11_CLIN0007CostProposalTemplate.xls
XLS spreadsheet 33 KB Posted
- Attached to
- A/B MAC CYCLE 2 JURISDICTION 6
- Solicitation number
- RFP-CMS-2007-0013
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J-11 CLIN 0007 Template
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CLIN-0007
| COST TEMPLATE - SAMPLE Attachment J-11 | ||||
| (Provide a cost spreadsheet for each CLIN proposed) | ||||
| CLIN 0007 | Workload Closeout Costs | |||
| A/B SERVICES/BASE YEAR | Total FTEs | |||
| Hours | Rates | Total | ||
| COST ELEMENTS | ||||
| Direct Labor | ||||
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| Add Other Appropriate Labor Categories (note: labor categories should match WBS) | 0 | $0.00 | $0 | |
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| 0 | $0.00 | $0 | ||
| 0 | $1.00 | $0 | ||
| Subtotal Direct Labor | 0 | $0 | ||
| Fringe Benefits (at ____%) | $0.00 | $0 | ||
| Total Direct Labor | $0 | |||
| Travel (see separate schedule) | $0 | |||
| SUBCONTRACTORS | ||||
| Subcontractor Name | 0 | $0 | ||
| Subcontractor Name | 0 | $0 | ||
| Subcontractor Name | 0 | $0 | ||
| Subcontractor Name | 0 | $0 | ||
| Subcontractor Name | 0 | $0 | ||
| Subcontractor Name | 0 | $0 | ||
| Total Subcontractor | 0 | $0 | ||
| Other Direct Costs (See separate schedule) | $0 | |||
| SUBTOTAL ALL DIRECT COSTS | $0 | |||
| Indirect Costs (at ______ %) | $0 | |||
| SUBTOTAL COSTS BEFORE FEE | $0 | |||
| Base Fee (at ____%) | ||||
| Award Fee (at ______%) | ||||
| TOTAL COSTS | $0 | |||
| Complementary Credits | ||||
| Note: comp.credit information will be provided by CMS prior to final proposal revision. Offerors should not propose amounts at this time. | ||||
| TOTAL COSTS |
&C&"Arial,Bold"&12RFP-CMS-2007-0013
PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)
&LAttachment J-11&R&P
ODC Schedule
| ODC SCHEDULE - SAMPLE | |
| (Provide an ODC Spreadsheet for each CLIN Proposed) | |
| CLIN 0007 A/B SERVICES | |
| Cost Element | TOTAL |
| Add costs by category | |
| TOTAL ODCs | $0.00 |
&C&"Arial,Bold"RFP-CMS-2007-0013 PART A & PART B (A/B) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)&"Arial,Regular" &LSLIN = Sub line item number
Attachment J-11&C &R&P
TRAVEL
| (Provide a Travel Spreadsheet for each CLIN) | |||||||||||||||||||||||||||||||||||||
| CLIN 0007 | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | Enter Purpose Here | GRAND TOTAL | |||||||||||||||||||||||||||
| No. | # | No. | # | No. | # | No. | # | No. | # | No. | # | No. | # | No. | # | No. | # | ||||||||||||||||||||
| Travel to: (Destination/Purpose) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A) X (B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A) X (B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A) X (B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | People (A) | Trips/Days (B) | Amount (C) | TOTAL ((A)X(B)) X (C) | TOTAL TRAVEL COSTS |
| Airfare | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Per Diem(SUM OF HOTEL/M&I) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Hotel | |||||||||||||||||||||||||||||||||||||
| Meals and Incidentals(M&I) | |||||||||||||||||||||||||||||||||||||
| Car Rental | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Local Trips | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Mileage | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Parking, Taxis, Other | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||||||||||||||||||||||||
| Total Travel | 0 | 0 | 0 | $0.00 | 0 | 0 | 0 | $0.00 | 0 | 0 | 0 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
&C&"Arial,Bold"&14RFP-CMS-2007-0013 A/B MAC Jurisdiction ____ Travel Cost Template &LAttachment J-11&R&P
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