A04 - IGE (Services)_HCAHPS_BFSU _vendor.xlsx

XLSX spreadsheet 46 KB Posted

Attached to
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey
Solicitation number
SS-BFSU-26-007
Issued by

About this file

Written by GovTribe AI ·

This file is an Independent Government Cost Estimate (IGCE) for a Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey project for the Indian Health Service (IHS) at the Browning, Montana (BFSU) location. The contract is structured for a base period and four option years, spanning from November 1, 2025, to October 31, 2030, with a primary scope of conducting monthly phone-based surveys of up to 60 patients, including implementation, set-up, and data transfer services.

The IGCE template shows a detailed cost breakdown with line items for survey services, fringe benefits, overhead, and other direct costs, though specific pricing is not populated in this version. The document indicates an assumed annual inflation rate of 2.25% and was prepared by Eva Racine on August 14, 2025. The related federal contract opportunity is a Sources Sought notice specifically targeting Indian Economic Enterprises (IEE) under the Buy Indian Act, with a NAICS code of 621498 and a size standard of $25.5 million, signaling a preference for Indian-owned businesses to perform the HCAHPS survey services.

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A05 - SOW_HCAHPS_BFSU.pdf PDF

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IGCE

HHS IGCE TEMPLATE
Project Title:BFSU HCAHPS
Location:BFSU, Browning MT 59417
Period of PerformanceUltimate Start:11/1/25Ultimate End:10/31/30
Note: This template can be modified based on the contract type (i.e. Firm Fixed Price, Time and Materials, and Cost Reimburesment)
Contract Line Item Description+A6Base PeriodOption Year OneOption Year TwoOption Year ThreeOption Year Four
QuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal Price
HCAHPS Phone Mode Surveys; Up to 60 patients surveyed monthly, Maintenance and Reporting12.00MO$ - 012.00MO$ - 012.00MO$ - 012.00MO$ - 012.00MO$ - 0
Implementation, Set-up and Data Transfer1.00EA$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Line Item Subtotal$ - 0$ - 0$ - 0$ - 0$ - 0
Fringe Benefits$ - 0$ - 0$ - 0$ - 0$ - 0
Subtotal Line Item & Fringe$ - 0$ - 0$ - 0$ - 0$ - 0
Overhead$ - 0$ - 0$ - 0$ - 0$ - 0
Subtotal Line Items, Fringe and Overhead$ - 0$ - 0$ - 0$ - 0$ - 0
OTHER DIRECT COSTS
Travel$ - 0$ - 0$ - 0$ - 0$ - 0
Subcontracts$ - 0$ - 0$ - 0$ - 0$ - 0
Consultants$ - 0$ - 0$ - 0$ - 0$ - 0
Materials$ - 0$ - 0$ - 0$ - 0$ - 0
CDs$ - 0$ - 0$ - 0$ - 0$ - 0
Subtotal ODCs$ - 0$ - 0$ - 0$ - 0$ - 0
Subtotal - All Costs$ - 0$ - 0$ - 0$ - 0$ - 0
G&A$ - 0$ - 0$ - 0$ - 0$ - 0
Total Cost$ - 0$ - 0$ - 0$ - 0$ - 0
Fee/Profit$ - 0$ - 0$ - 0$ - 0$ - 0
Total Estimated Yearly Values$ - 0$ - 0$ - 0$ - 0$ - 0
TOTAL ESTIMATED VALUE OF CONTRACT$ - 0
Assumptions:Percent
Inflation Rate Per Year2.25%Estimate Prepared by:Eva Racine
Fringe Benefits Rate0.00%Date Prepared:8/14/25
Overhead Rate0.00%
G&A Rate0.00%Signature:Eva Racine
Fee/Profit Percentage0.00%

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