INSTRUCTIONS FOR TRAVEL DETAIL FORM
RFP Number
Enter the CMS Request for Proposal (RFP) number for the proposed contract (make sure the information is entered in the box shown at cell A6) in worksheet Year 1. Note: This information is linked throughout the following worksheets.
Name and Address of QIO Organization
Enter the name and address of the organization submitting the proposal (make sure the information is entered in the boxes shown at cells B6, B7 and B8) in worksheet Year 1. Note: This information is linked throughout the following worksheets.
QIO Area (State)
Enter the state or other area that the proposed QIO contract will cover (make sure the information is entered in the box shown at cell G6) in worksheet Year 1. Note: This information is linked throughout the following worksheets.
Proposed Contract Period
Enter the beginning and ending dates of the proposed QIO contract (make sure the information is entered in the boxes shown at cells K6 and K7) in worksheet Year 1. Note: This information is linked throughout the following worksheets.
Mileage Rate.
QIOs should enter the current Federal Travel Regulation mileage rate used for the proposed QIO contract.
Trip Title & Description.
Enter a proposed trip title and provide a brief description of the purpose of the trip.
# of Days per Trip.
Enter the proposed number of days for the trip.
# of Nights per Trip.
Enter the proposed number of nights for the trip.
# of Travelers per Trip.
QIOs should enter the number of travelers, per trip, in whole figures.
Airfare per Person.
QIOs should enter the proposed airfare per person.
Departing from.
Enter the city and state the travelers are departing from.
Arriving to.
Enter the city and state the travelers will arrive to.
FTR Meals & Inc. Daily Rate.
QIOs must enter the current Federal Travel Regulations (FTR) Meals and Incidental Rate for the current year based on www.gsa.gov. Note: The formula embedded in the Total column will calculate the max Per Diem rate for the first and last day based on the number of days reported previously.
FTR Lodging per Night.
QIOs must enter the current Federal Travel Regulations (FTR) maximum Lodging Rate (excluding taxes) for the Primary Destination for each trip based on www.gsa.gov. Note: The formula embedded in the Total column will calculate the lodging costs based on the nights reported previously.
# of Trips for Year 1, 2, or 3.
Enter the number of trips for the respective year.
Mileage.
Input the total number of miles per trip for all travelers, if applicable.
# of Rental Cars per Trip.
Enter the number of rental cars needed for each trip.
Daily Rental Car Rate.
Enter the proposed daily rental car rate.
Miscellaneous Cost per Person per Trip.
Enter the miscellaneous cost per person per trip. You may include parking fees, gas, taxi, metro fees, and the like.
Notes.
Provide a detailed explanation of the proposed miscellaneous cost calculations (what and how your organization reached the proposed figures).
** Shaded cells represent no entry required.
| File Type | application/msword |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |