RHTP Evaluation Cost Proposal Form.xlsx
XLSX spreadsheet 30 KB Posted
- Solicitation number
- RFP - 10A - 202601009
- Issued by
- Maine
About this file
This is a Cost Proposal Form for Request for Proposals #202601009 issued by the State of Maine Department of Health and Human Services for evaluation services of Maine's Rural Health Transformation Program. Bidders are required to provide comprehensive cost proposals covering a five-year procurement period divided into three 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. The cost proposal must include all expenses associated with performing and delivering evaluation services as outlined in the RFP, with separate budget schedules provided for each contract phase. Costs should be submitted as a total fixed amount and must include detailed line-item breakdowns for salaries by position with hourly rates, subcontractor and consultant costs, travel expenses consistent with Maine state travel policies, and supplies with appropriate justifications.
The cost proposal form requires bidders to submit hourly rates for any positions that may be assigned ad-hoc work resulting from the contract; however, these ad-hoc rates will not be used or considered during the evaluation process and should not be included in the total contract cost. Bidders must ensure that all salary, subcontractor, travel, and supply costs are accurately calculated and that formulas within the budget form calculate correctly when additional lines are added. No specific budget ceiling or award value range is disclosed in the form. Travel reimbursement must comply with Maine's established travel policies, with detailed justification required for all travel-related expenses.
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Other files
| File | Type | Posted |
|---|---|---|
| AMD 2 RFP 202601009 Final.docx | DOCX document | |
| RFP 202601009 RHTP Evaluation_Final.docx | DOCX document | |
| 202601009 Eval of RHTP - Final.xlsx | XLSX spreadsheet | |
| 17 Feb26_V4_SoM_RHTP_Project Narrative.pdf | ||
| AMD 1 RFP 202601009 Final.docx | DOCX document | |
| RHTP Evaluation Cost Proposal Form.xlsx | XLSX spreadsheet | |
| RHTP Evaluation Proposed Services Response Form.docx | DOCX document | |
| AMD 1 RFP 202601009 Final.docx | DOCX document | |
| RHTP Evaluation Proposed Services Response Form.docx | DOCX document | |
| RFP 202601009 RHTP Evaluation_Final.docx | DOCX document | |
| RFP 202601009 RHTP Evaluation_Final.docx | DOCX document | |
| RHTP Evaluation Proposed Services Response Form.docx | DOCX document | |
| RHTP Evaluation Cost Proposal Form.xlsx | XLSX spreadsheet |
Show all 13
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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. | |||
| Line | Deliverables | Cost | |
| 1 | Initial Period of Performance (6/1/2026 - 5/31/2028) | ||
| (Schedule 2) | $ - 0 | ||
| 2 | Renewal Period #1 (6/1/2028 - 5/31/2030) | ||
| (Schedule 3) | $ - 0 | ||
| 3 | Renewal Period #2 (6/1/2030 - 5/31/2031) | ||
| (Schedule 4) | $ - 0 | ||
| 4 | Total 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) | ||||||||
| 1 | Salaries | |||||||
| (list positons proposed for this RFP and the rate for each) | Hourly Rate | x | Total # of Hours | = | Amount | |||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| 2 | Total 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/travel | Amount |
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) | ||||||||
| 1 | Salaries | |||||||
| (list positons proposed for this RFP and the rate for each) | Hourly Rate | x | Total # of Hours | = | Amount | |||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| 2 | Total 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/travel | Amount |
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) | ||||||||
| 1 | Salaries | |||||||
| (list positons proposed for this RFP and the rate for each) | Hourly Rate | x | Total # of Hours | = | Amount | |||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| x | = | $0.00 | ||||||
| 2 | Total 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/travel | Amount |
Supplies - Justification
| Total Other Expenses | $0.00 |
| Total Cost | $0.00 |
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