J-07 Basis of Estimate.xlsx

XLSX spreadsheet 72 KB Posted Dec 30, 2009

Attached to: DME MAC Jurisdiction A Federal contract opportunity
Solicitation number: RFP-CMS-2010-0004
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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J-07 Basis of Estimate

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J-14_CLIN_0005_Cost_Proposal_Templates_Option_Period_3.xlsx	XLSX spreadsheet	Jan 28, 2010
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Amendment 000002 JA.docx	DOCX document	Jan 28, 2010
J-11_CLIN_0002_Cost_Proposal_Templates_Base_Period.xlsx	XLSX spreadsheet	Jan 28, 2010
J-10_CLIN_0001_Cost_Proposal_Templates_Implementation.xls	XLS spreadsheet	Jan 28, 2010
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RFP-CMS-2010-0004_DME MAC Juris A RFP Q As_ 01_28_10.xls	XLS spreadsheet	Jan 28, 2010
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J-10_CLIN_0001_Cost_Proposal_Templates_Implementation.xlsx	XLSX spreadsheet	Jan 28, 2010
Attachment J-19 Implementation Handbook redline.doc	DOC document	Jan 28, 2010
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J-13_CLIN_0004_Cost_Proposal_Templates_Option_Period_2.xls	XLS spreadsheet	Jan 28, 2010
J-13_CLIN_0004_Cost_Proposal_Templates_Option_Period_2.xlsx	XLSX spreadsheet	Jan 28, 2010
J-15_CLIN_0006_Cost_Proposal_Templates_Option_Period_4.xls	XLS spreadsheet	Jan 28, 2010
J-14_CLIN_0005_Cost_Proposal_Templates_Option_Period_3.xls	XLS spreadsheet	Jan 28, 2010
J-16_CLIN_0007_Cost_Proposal_Templates_Close_Out_Period.xlsx	XLSX spreadsheet	Jan 28, 2010
J-02_Deliverables_DME_MAC_redline.xlsx	XLSX spreadsheet	Jan 28, 2010
Amendment 00002.pdf	PDF	Jan 28, 2010
J-11_CLIN_0002_Cost_Proposal_Templates_Base_Period.xls	XLS spreadsheet	Jan 28, 2010
Amendment 00001 JA.docx	DOCX document	Jan 6, 2010
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RFP-CMS-2010-0004_Jurisdiction A_SF30_Amendment 1.pdf	PDF	Jan 6, 2010
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J-01 Statement of Work 12-22-09.docx	DOCX document	Dec 30, 2009
J-09_Cost Proposal Instructions.xls	XLS spreadsheet	Dec 30, 2009
J-02 Deliverables_DME MAC.xlsx	XLSX spreadsheet	Dec 30, 2009
J-01B SoW appendices.doc	DOC document	Dec 30, 2009
J-10 CLIN 0001 Cost Proposal Templates Implementation.xlsx	XLSX spreadsheet	Dec 30, 2009
J-05 GFP-GFI_DME MAC.xlsx	XLSX spreadsheet	Dec 30, 2009
J-03 SmallBusinessSubcontractingPlan.doc	DOC document	Dec 30, 2009
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J-15 CLIN 0006 Cost Proposal Templates Option Period 4.xlsx	XLSX spreadsheet	Dec 30, 2009
J-06 Sample Award fee Plan	—	Dec 30, 2009
J-22 Contractors Guide for Gov Property 12 09 08.pdf	PDF	Dec 30, 2009
J-01A MAC Shared System BaseNonbase.doc	DOC document	Dec 30, 2009
J-12 CLIN 0003 Cost Proposal Templates Option Period 1.xlsx	XLSX spreadsheet	Dec 30, 2009
J-24_DirectionsToCentralOffice.pdf	PDF	Dec 30, 2009
Solicitation DME MAC A_coverletter.docx	DOCX document	Dec 30, 2009
RFP-CMS-2010-0004_Jurisdiction A_SF33.pdf	PDF	Dec 30, 2009
J-11 CLIN 0002 Cost Proposal Templates Base Period.xlsx	XLSX spreadsheet	Dec 30, 2009
J-08 PastPerformanceQuestionnaire.doc	DOC document	Dec 30, 2009
J-18 NonDisclosure Statement.doc	DOC document	Dec 30, 2009
J-16 CLIN 0007 Cost Proposal Templates Close Out Period.xlsx	XLSX spreadsheet	Dec 30, 2009
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J-21 Corporate Experience Attestation.doc	DOC document	Dec 30, 2009
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J-17 Proposal Checklist.doc	DOC document	Dec 30, 2009
J-20 Information Security Attestation.docx	DOCX document	Dec 30, 2009

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Instructions

DME MAC Business Proposal

Basis of Estimate - Template Instructions

To provide CMS with an understanding of the Offeror's basis of estimate, the Offeror shall complete this template for the Base Year and Option Year One as part of its Volume II submission. CMS is providing instructions to the Offeror for populating this template below. In addition, CMS has provided a sample calculation for the Offeror under the Base Year Tab.

	Column A,
Cost Estimating Factor	The first column of the spreadsheet has the workload categories identified in RFP section L. Note: In instances where Section L describes "provider counts" (i.e., Provider Customer Service), the Offeror shall provide the workload assumptions used in its Proposal based on the number of providers identified in the RFP. The Offeror shall insert a separate row for each workload category under the high-level workload category (shaded in grey) provided in the template.The Offeror shall copy and paste the FTE calculation formula in Column G for each inserted row. Also, the Offeror shall insert its proposed workload (by category) identified in its Medical Review Strategy (Tab F, Volume I) for Automated Reviews under the Medical Review heading. At a minimum, the Offeror shall include the categories identified in this Attachment. However, the Offeror is instructed to insert additional rows for Automated Reviews as necessary based on the categories proposed in its Medical Review Strategy. The Offeror shall copy and paste any formulas in the worksheet for each inserted row.
	Column B,
Annual Workload	The Offeror shall identify the RFP workloads for each cost estimating factor subheading in either light blue or grey (see the example provided in Red under the Base Year Tab). The Offeror shall also provide the annual workload for each workload category using Column B. The annual workload represents the portion of the total functional workload that is projected to be impacted by the specific labor category in Column B (Position / Labor Category). For example, if Claims Analyst I performs some function in handling all paper claims, the workload touched by this position would equate to the total paper claims volume. However, if Claims Analyst I only handles 75% of paper claims, with 25% handled by a Claims Analyst II, this would be reflected in a workload number 75% of that quoted in the RFP Section L. Any workloads listed must tie back to those identified in Section L of the RFP. NOTE: A formula is provided in the template to calculate the workload for each labor category following each sub-heading shaded light blue or grey. However, the Offeror shall ensure that the formula is updated to reflect any new/inserted rows.

	Column C,
% Workload Processed with Direct Labor	For each workload category identified in Column A, the Offeror shall identify in Column C the percentage of the annual workload (Column B) that will be processed using direct labor.
	Column D,
Position/Labor Category	For each workload category identified in Column A, the Offeror shall identify in Column D all positions/labor catagories required to meet the functional requirements of the statement of work. Each position/labor category shall be displayed using a separate row. Note: This may require the Offeror to insert additional rows. The Offeror shall copy and paste all formulas in the worksheet for each inserted row. For manager and supervisor positions/labor categories, the Offeror is instructed to adjust formulas as needed and insert the FTEs based its own proposal assumptions.
	Column E,
Annual Productive Hours	The Offeror shall provide the annual productive hours for each position/labor category (identified in Column D) using Column E.
	Column F,
Daily Production per FTE	The Offeror shall provide the workload that can be accomplished by one (1) FTE in one (1) business day using Column E. For this template, one (1) business day is defined as eight (8) hours. For example, if Claims Analyst I requires an average of 24 minutes to complete the position-specific tasks for a single paper claim, the Daily Production per FTE for this position would be 20 paper claims (2.5 claims per hour x 8 hours in a day).
	Column G,
Total FTEs	Column G contains a formula (in unshaded rows only) to automatically calculated total FTEs for each position/labor category provided by the Offeror. This should reflect the CLIN templates submitted with the Offeror's Business Proposal. Note: For all high-level workload headings (dark blue shading) and sub-headings (light blue or grey), the offeror shall provide a sum of the total FTEs (see example provided under the Base Year tab).
	Column H,
% Workload Processed by Indirect Cost Center	Where applicable, for each workload category identified in Column A, the Offeror shall identify in Column H the percentage of the annual workload (Column B) that will be processed by an Indirect Cost Center.
	Column I,
CLIN Template Crosswalk	The Offeror shall provide a crosswalk to the CLIN templates for the FTEs identified for each workload category using Column I.
	Column J,
Basis of Estimate	The Offeror shall specify whether the proposed productivity for each labor category is based on its history, or if it is based on a new innovation and/or process improvement proposed for this contract. The Offeror shall also crosswalk any referenced new innovation and/or process improvement in this column to the page, tab, and Volume of its Proposal that contains the narrative describing this innovation/process improvement (e.g., Volume I, Tab G, page 26). In addition, if the basis of the Offeror's proposed productivity is its history, which includes an implemented innovation and/or process improvement referenced in another section of its Proposal, the Offeror shall also crosswalk this to the page, tab, and Volume of its Proposal that contains the applicable narrative to support this implemented innovation and/or process improvement. Note: For the Bills/Claims workload, the Offeror shall notate the Suspence rates used in development of their Bills/Claims productivity estimates for both EMC and Paper claims using the light blue sub-headings (see example provided under the Base Year tab).
	NOTE: The Offeror shall only provide Attachment J-03 via CD-ROM. The Offeror shall not submit hard copies of this document.

RFP-CMS-2010-0004

DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)

Attachment J-03 Basis of Estimate Source Selection Information - See FAR 2.101 and 3.104 &P

Base Year

	J_ DME MAC Volume II
	Basis of Estimate - Base Year
	Example
	Cost Estimating Factor	Annual
Workload1	% Workload Processed with Direct Labor	Position/Labor Category	Annual Productive
Hours2	Daily Production per FTE2	Total FTEs	% Workload Processed with Indirect Cost Center	CLIN Template Crosswalk	Basis of Estimate
	Bills/Claims						54.41
	Bills Claims - EMC	6,121,955					0.01		History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
	Bills/Claims - EMC	9,795	0.16%	Claims Analyst I	1,864.00	3,200.00	0.01	All CLIN 0002, SLINAA, SOW D.1.2	History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
	Bills Claims - Paper	145,524					51.53		New - Paper suspense rate of 9% on new OCR technology (see page 20, Tab E, Volume I)
	Bills/Claims - Paper	50,933	35.00%	Claims Analyst I	1,864.00	20.00	10.93	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on new OCR technology implemented in 2007 (see page 17, Tab E, Volume I)
	Bills/Claims - Paper	94,591	65.00%	Claims Analyst II	1,864.00	10.00	40.60	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on automated process flow implemented in 2006 (see page 17, Tab E, Volume I)
	Claims Backlog - Pending Claims	1,556,129					2.87
	Claims Backlog - Pending Claims	2,440	0.16%	Claims Analyst I	1,864.00	20.00	0.52	All CLIN 0002, SLINAA, SOW D.1.2	History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
	Claims Backlog - Pending Claims	10,893	35.00%	Claims Analyst I	1,864.00	20.00	2.34	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on new OCR technology implemented in 2007 (see page 17, Tab E, Volume I)
	Claims Backlog - Pending Claims	32	65.00%	Claims Analyst II	1,864.00	10.00	0.01	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on automated process flow implemented in 2006 (see page 17, Tab E, Volume I)
	Appeals Part B
	Written Redeterminations
	Written Redeterminations	0					ERROR:#DIV/0!
	QIC Requests Supported
	QIC Requests Supported	0					ERROR:#DIV/0!
	Redeterminations on RAC Determinations
	Redeterminations on RAC Determinations	0					ERROR:#DIV/0!
	Clerical Error Reopenings
	Clerical Error Reopenings	0					ERROR:#DIV/0!
	Non-Clerical Error Reopenings
	Non-Clerical Error Reopenings	0					ERROR:#DIV/0!
	Effectuations
	Effectuations	0					ERROR:#DIV/0!
	ALJ Hearings
	ALJ Hearings	0					ERROR:#DIV/0!
	Appeals Backlog - Pending Redeterminations
	Appeals Backlog - Pending Redeterminations	0					ERROR:#DIV/0!
	PM Beneficiary Inquiries
	Complex Beneficiary Inquiry Responses
	Complex Beneficiary Inquiry Responses	0					ERROR:#DIV/0!
	Complex 2nd Level Screenings
	Complex 2nd Level Screenings	0					ERROR:#DIV/0!
	PM Provider Customer Service
	Provider Inquiries
	Telephone Inquiries
	Telephone Inquiries	0					ERROR:#DIV/0!
	Written Inquiries
	Written Inquiries	0					ERROR:#DIV/0!
	Inquiries Backlog - Written Correspondence Pending
	Inquiries Backlog - Written Correspondence Pending	0					ERROR:#DIV/0!
	Congressionals
	Congressionals	0					ERROR:#DIV/0!
	PM Non-MSP collections (including RAC)
	Non-MSP collections
	Non-MSP collections	0					ERROR:#DIV/0!
	PM Change Management
	Draft Change Requests	0
	Draft Change Requests	0					ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes	0
	Finalized and Issued Change Requests - Shared System Changes	0					ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes	0
	Finalized and Issued Change Requests - No Shared System Changes	0					ERROR:#DIV/0!
	MIP Medical Review (MR)
	Routine Manual Medical Reviews
	Routine Manual Medical Reviews	0					ERROR:#DIV/0!
	Existing LCDs Revised
	Existing LCDs Revised	0					ERROR:#DIV/0!
	New LCDs Developed
	New LCDs Developed	0					ERROR:#DIV/0!
	Prepay Complex Probe Reviews
	Prepay Complex Probe Reviews	0					ERROR:#DIV/0!
	Postpay Complex Probe Reviews
	Postpay Complex Probe Reviews	0					ERROR:#DIV/0!
	Prepay Complex Reviews
	Prepay Complex Reviews	0					ERROR:#DIV/0!
	Postpay Complex Reviews
	Postpay Complex Reviews	0					ERROR:#DIV/0!
	Medical Review Reopenings
	Medical Review Reopenings	0					ERROR:#DIV/0!
	Medical Review Claims Overturned on First Level Appeal
	Medical Review Claims Overturned on First Level Appeal	0					ERROR:#DIV/0!
	Medical Review Advanced Determination of Medicare Coverage (ADMC) Requests
	Medical Review Advanced Determination of Medicare Coverage (ADMC) Requests	0					ERROR:#DIV/0!
	Medical Review Data Requests
	Medical Review Data Requests	0					ERROR:#DIV/0!
	Medical Review Limited Education
	Medical Review Limited Education	0					ERROR:#DIV/0!
	Automated Reviews
	Automated reviews developed based on the contractors own LCDs
	Automated reviews developed based on the contractors own LCDs	0					ERROR:#DIV/0!
	Medically Unlikely Edits
	Medically Unlikely Edits	0					ERROR:#DIV/0!
	Not Correct Coding Initiative Edits
	Not Correct Coding Initiative Edits	0					ERROR:#DIV/0!
	Not National Coverage Determination Edits
	Not National Coverage Determination Edits	0					ERROR:#DIV/0!
	MIP MSP Prepay
	Claims Edits Resolved / "I" Records Resolved
	Claims Edits Resolved / "I" Records Resolved	0					ERROR:#DIV/0!
	COBC Claims Transferred
	COBC Claims Transferred	0					ERROR:#DIV/0!
	MIP Benefit Integrity Part B Workload
	PSC Support Requests-Non Law Enforcement
	PSC Support Requests-Non Law Enforcement	0					ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement
	PSC Support Requests- Law Enforcement	0					ERROR:#DIV/0!
	# of PSC Support Services Provided - Overpayments Recouped
	# of PSC Support Services Provided - Overpayments Recouped	0					ERROR:#DIV/0!
	MIP Provider Customer Service
	MIP MSP Postpay
	Provider/Supplier Duplicate Primary Payments
	Provider/Supplier Duplicate Primary Payments	0					ERROR:#DIV/0!
	General MSP Inquiries Resolved
	General MSP Inquiries Resolved	0					ERROR:#DIV/0!
	Debt Collection and Referrals
	Debt Collection and Referrals	0					ERROR:#DIV/0!

&14RFP-CMS-2010-0004

DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)

&X1 &XWorkload supplied in Section L of the solicitation&X 2&X Supplied by Offeror (one day is defined as 8 hours).

Source Selection Information - See FAR 2.101 and 3.104 &P

Option Year One

J_ DME MAC Volume II

Basis of Estimate - Option Year One

	Cost Estimating Factor	Annual
Workload1	% Workload Processed with Direct Labor	Position/Labor Category	Annual Productive
Hours	Daily Production per FTE2	Total FTEs	% Workload Processed with Indirect Cost Center	CLIN Template Crosswalk	Basis of Estimate
	Bills/Claims
	Bills Claims - EMC
	Bills/Claims - EMC	0				ERROR:#DIV/0!
	Bills Claims - Paper
	Bills/Claims - Paper	0				ERROR:#DIV/0!
	Claims Backlog - Pending Claims
	Claims Backlog - Pending Claims	0				ERROR:#DIV/0!
	Appeals Part B
	Written Redeterminations
	Written Redeterminations	0				ERROR:#DIV/0!
	QIC Requests Supported
	QIC Requests Supported	0				ERROR:#DIV/0!
	Redeterminations on RAC Determinations
	Redeterminations on RAC Determinations	0				ERROR:#DIV/0!
	Clerical Error Reopenings
	Clerical Error Reopenings	0				ERROR:#DIV/0!
	Non-Clerical Error Reopenings
	Non-Clerical Error Reopenings	0				ERROR:#DIV/0!
	Effectuations
	Effectuations	0				ERROR:#DIV/0!
	ALJ Hearings
	ALJ Hearings	0				ERROR:#DIV/0!
	Appeals Backlog - Pending Redeterminations
	Appeals Backlog - Pending Redeterminations	0				ERROR:#DIV/0!
	PM Beneficiary Inquiries
	Complex Beneficiary Inquiry Responses
	Complex Beneficiary Inquiry Responses	0				ERROR:#DIV/0!
	Complex 2nd Level Screenings
	Complex 2nd Level Screenings	0				ERROR:#DIV/0!
	PM Provider Customer Service
	Provider Inquiries
	Telephone Inquiries
	Telephone Inquiries	0				ERROR:#DIV/0!
	Written Inquiries
	Written Inquiries	0				ERROR:#DIV/0!
	Inquiries Backlog - Written Correspondence Pending
	Inquiries Backlog - Written Correspondence Pending	0				ERROR:#DIV/0!
	Congressionals
	Congressionals	0				ERROR:#DIV/0!
	PM Non-MSP collections (including RAC)
	Non-MSP collections
	Non-MSP collections	0				ERROR:#DIV/0!
	PM Change Management
	Draft Change Requests	0
	Draft Change Requests	0				ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes	0
	Finalized and Issued Change Requests - Shared System Changes	0				ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes	0
	Finalized and Issued Change Requests - No Shared System Changes	0				ERROR:#DIV/0!
	MIP Medical Review (MR)
	Routine Manual Medical Reviews
	Routine Manual Medical Reviews	0				ERROR:#DIV/0!
	Existing LCDs Revised
	Existing LCDs Revised	0				ERROR:#DIV/0!
	New LCDs Developed
	New LCDs Developed	0				ERROR:#DIV/0!
	Prepay Complex Probe Reviews
	Prepay Complex Probe Reviews	0				ERROR:#DIV/0!
	Postpay Complex Probe Reviews
	Postpay Complex Probe Reviews	0				ERROR:#DIV/0!
	Prepay Complex Reviews
	Prepay Complex Reviews	0				ERROR:#DIV/0!
	Postpay Complex Reviews
	Postpay Complex Reviews	0				ERROR:#DIV/0!
	Medical Review Reopenings
	Medical Review Reopenings	0				ERROR:#DIV/0!
	Medical Review Claims Overturned on First Level Appeal
	Medical Review Claims Overturned on First Level Appeal	0				ERROR:#DIV/0!
	Medical Review Advanced Determination of Medicare Coverage (ADMC) Requests
	Medical Review Advanced Determination of Medicare Coverage (ADMC) Requests	0				ERROR:#DIV/0!
	Medical Review Data Requests
	Medical Review Data Requests	0				ERROR:#DIV/0!
	Medical Review Limited Education
	Medical Review Limited Education	0				ERROR:#DIV/0!
	Automated Reviews
	Automated reviews developed based on the contractors own LCDs
	Automated reviews developed based on the contractors own LCDs	0				ERROR:#DIV/0!
	Medically Unlikely Edits
	Medically Unlikely Edits	0				ERROR:#DIV/0!
	Not Correct Coding Initiative Edits
	Not Correct Coding Initiative Edits	0				ERROR:#DIV/0!
	Not National Coverage Determination Edits
	Not National Coverage Determination Edits	0				ERROR:#DIV/0!
	MIP MSP Prepay
	Claims Edits Resolved / "I" Records Resolved
	Claims Edits Resolved / "I" Records Resolved	0				ERROR:#DIV/0!
	COBC Claims Transferred
	COBC Claims Transferred	0				ERROR:#DIV/0!
	MIP Benefit Integrity Part B Workload
	PSC Support Requests-Non Law Enforcement
	PSC Support Requests-Non Law Enforcement	0				ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement
	PSC Support Requests- Law Enforcement	0				ERROR:#DIV/0!
	# of PSC Support Services Provided - Overpayments Recouped
	# of PSC Support Services Provided - Overpayments Recouped	0				ERROR:#DIV/0!
	MIP Provider Customer Service
	MIP MSP Postpay
	Provider/Supplier Duplicate Primary Payments
	Provider/Supplier Duplicate Primary Payments	0				ERROR:#DIV/0!
	General MSP Inquiries Resolved
	General MSP Inquiries Resolved	0				ERROR:#DIV/0!
	Debt Collection and Referrals
	Debt Collection and Referrals	0				ERROR:#DIV/0!

&14RFP-CMS-2010-0004

DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC)

&X1&X Workload supplied in Section L of the solicitation &X2&X Supplied by Offeror (one day is defined as 8 hours).

Source Selection Information - See FAR 2.101 and 3.104 &P

File details come from the government source that posted it. Updated Nov 14, 2017.