RHTP Evaluation Cost Proposal Form.xlsx

XLSX spreadsheet 30 KB Posted

Attached to
Evaluation of Maine's Rural Health Transformation Program
Solicitation number
RFP - 10A - 202601009
Issued by
Maine

About this file

This is a cost proposal form for the State of Maine Department of Health and Human Services related to RFP #202601009 for the evaluation of Maine's Rural Health Transformation Program. The procurement spans a five-year period divided into three distinct phases: an initial period of performance from June 1, 2026 through May 31, 2028; Renewal Period #1 from June 1, 2028 through May 31, 2030; and Renewal Period #2 from June 1, 2030 through May 31, 2031. Bidders must provide comprehensive cost proposals for all services outlined in the RFP for each period, with separate budget schedules required for each phase of the contract.

The cost proposal form requires bidders to detail salaries by position and hourly rates, subcontractor and consultant costs, travel expenses in accordance with Maine's state travel policies, and supplies. Bidders must complete designated white spaces on the budget forms while ensuring existing formulas calculate correctly, with caution advised when adding additional line items. The form includes a section for ad-hoc work hourly rates by position, though these rates are explicitly noted as not being used or considered during the evaluation process. All cost information must be submitted on the structured schedules provided, with totals automatically calculated for each renewal period and the overall five-year procurement period.

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AMD 1 RFP 202601009 Final.docx DOCX document
RHTP Evaluation Cost Proposal Form.xlsx XLSX spreadsheet
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RFP 202601009 RHTP Evaluation_Final.docx DOCX document
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Text version

Schedule 1 - Total Cost

State of Maine
Department of Health and Human Services
COST PROPOSAL FORM
RFP# 202601009
Evaluation of Maine’s Rural Health Transformation Program
Bidder Name:
Contact Person:
Instructions: Provide all cost for the 5-year procurement period to perform and deliver all services as outline in the RFP. In addition, provide cost associate with any ad-hoc work related to the evaluation services and requested by the Department.
LineDeliverablesCost
1Initial Period of Performance (6/1/2026 - 5/31/2028)
(Schedule 2)$ - 0
2Renewal Period #1 (6/1/2028 - 5/31/2030)
(Schedule 3)$ - 0
3Renewal Period #2 (6/1/2030 - 5/31/2031)
(Schedule 4)$ - 0
4Total Cost$ - 0
Ad-Hoc Work
Instructions: Bidders must provide hourly rates of positions in which ad-hoc work is requested under the contract resulting from this RFP. Ad-hoc rates will not be used or considered during the evaluation process.
Position(s)Hourly Rate

Schedule 2 - Initial Period

State of Maine
Department of Health and Human Services
COST PROPOSAL FORM
RFP# 202601009
Evaluation of Maine’s Rural Health Transformation Program
Bidder Name:
Contact Person:
Bidders must complete the budget form by entering data in the white spaces. Bidders should take caution when adding additional lines ensuring existing formulas calculate correctly. Do not include any cost related to ad-hoc work.
Initial Period of Performance (6/1/2026 - 5/31/2028)
1Salaries
(list positons proposed for this RFP and the rate for each)Hourly RatexTotal # of Hours=Amount
x=$0.00
x=$0.00
x=$0.00
x=$0.00
2Total Salary$0.00
Subcontractor(s)/Consultant(s)Amount
Total Subcontractor Costs$0.00
Other
Travel - Justification
Provide all related travel costs (i.e. mileage, lodging, airfare, incidentals, etc.) Travel reimbursement must align with the State's travel policies. https://www.maine.gov/osc/travelAmount

Supplies - Justification

Total Other Expenses$0.00
Total Cost$0.00

Schedule 3 - Renewal 1

State of Maine
Department of Health and Human Services
COST PROPOSAL FORM
RFP# 202601009
Evaluation of Maine’s Rural Health Transformation Program
Bidder Name:
Contact Person:
Bidders must complete the budget form by entering data in the white spaces. Bidders should take caution when adding additional lines ensuring existing formulas calculate correctly. Do not include any cost related to ad-hoc work.
Renewal Period #1 (6/1/2028 - 5/31/2030)
1Salaries
(list positons proposed for this RFP and the rate for each)Hourly RatexTotal # of Hours=Amount
x=$0.00
x=$0.00
x=$0.00
x=$0.00
2Total Salary$0.00
Subcontractor(s)/Consultant(s)Amount
Total Subcontractor Costs$0.00
Other
Travel - Justification
Provide all related travel costs (i.e. mileage, lodging, airfare, incidentals, etc.) Travel reimbursement must align with the State's travel policies. https://www.maine.gov/osc/travelAmount

Supplies - Justification

Total Other Expenses$0.00
Total Cost$0.00

Schedule 4 - Renewal 2

State of Maine
Department of Health and Human Services
COST PROPOSAL FORM
RFP# 202601009
Evaluation of Maine’s Rural Health Transformation Program
Bidder Name:
Contact Person:
Bidders must complete the budget form by entering data in the white spaces. Bidders should take caution when adding additional lines ensuring existing formulas calculate correctly. Do not include any cost related to ad-hoc work.
Renewal Period #2 (6/1/2030 - 5/31/2031)
1Salaries
(list positons proposed for this RFP and the rate for each)Hourly RatexTotal # of Hours=Amount
x=$0.00
x=$0.00
x=$0.00
x=$0.00
2Total Salary$0.00
Subcontractor(s)/Consultant(s)Amount
Total Subcontractor Costs$0.00
Other
Travel - Justification
Provide all related travel costs (i.e. mileage, lodging, airfare, incidentals, etc.) Travel reimbursement must align with the State's travel policies. https://www.maine.gov/osc/travelAmount

Supplies - Justification

Total Other Expenses$0.00
Total Cost$0.00

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