{"text_format":"3","workbook":"xlsx","n_sheets":1,"sheets":["Sheet1"],"read":"whole","date_system":"1900"}

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[null,"ATTACHMENT H\nFEE SCHEDULE FORM"]
[]
[null,"The Contractor shall provide all labor, equipment, manpower and other resources necessary to provide the services in strict accordance with the scope of services defined in the contract for the amounts specified in this Fee Schedule Form.\n\nThe County will only accept proposals in the following format. Any proposals that do not confirm to this format will be considered non-responsive and will not be accepted. It is expected that the awarded Contractor will assume all current open claims. Administrative expenses shall include all system download charges, home office support charges and any other support type costs including non-dedicated clerical staff, check stock, postage, supplies, telephonic reporting charges, medical network access fees etc. Staffing is based on current levels of staffing. If staffing is increased or decreased during the contract term, the monthly charges will be subject to the rates provided. If positions are vacant during a month, the charges will be reduced on a pro-rata basis for that month."]
[]
[null,"PROGRAM PRICING \nDEDICATED STAFF COSTS"]
[]
[null,"Liability/Property/Auto Liability and Auto Physical*"]
[null,"ITEM NO.","DESCRIPTION","ESTIMATED QUANTITY","PRICE PER MONTH"," x12","ANNUAL TOTAL PRICE"]
[null,"1.      ","Supervisor",1,null,12,{"$f":"E9*F9","v":0}]
[null,"2.      ","Senior Adjuster",1,null,12,{"$f":"E10*F10","v":0}]
[null,"3.      ","Adjuster",1,null,12,0]
[null,"Subtotal of lines 1 through 3",{"$nulls":4},{"$f":"SUM(G9:G11)","v":0}]
[]
[null,"Workers Compensation"]
[null,"ITEM NO.","DESCRIPTION","ESTIMATED QUANTITY","PRICE PER MONTH"," x12","ANNUAL TOTAL PRICE"]
[null,4,"Supervisor",1,null,12,{"$f":"E16*F16","v":0}]
[null,5,"Senior Lost Time Adjuster",1,null,12,0]
[null,"6.      ","Lost Time Adjuster",1,null,12,0]
[null,"7.      ","Medical Only Adjuster",1,null,12,0]
[null,"8.      ","Adjuster Assistant (shared with liability staff)",1,null,12,0]
[null,"Subtotal of lines 4 through 7",{"$nulls":4},{"$f":"SUM(G16:G20)","v":0}]
[]
[null,"Telephonic Case Management"]
[null,"ITEM NO.","DESCRIPTION","ESTIMATED QUANTITY","PRICE PER MONTH"," x12","ANNUAL TOTAL PRICE"]
[null,"9.      ","Supervisor",1,null,12,{"$f":"E25*F25","v":0}]
[null,"10.      ","Telephonic Nurse Case Manager",1,null,12,0]
[null,"11.      ","Telephonic Case Management Assistant",1,null,12,0]
[null,"12.      ","Administrative Support Fee",1,null,12,0]
[null,"Subtotal of lines 9 through 12",{"$nulls":4},{"$f":"SUM(G25:G28)","v":0}]
[]
[null,"PROGRAM COSTS\nALLOCATED EXPENSES"]
[]
[null,"Medical Costs"]
[null,"ITEM NO.","DESCRIPTION","ESTIMATED QUANTITY INVOICES","PRICE PER MONTH"," x12","ANNUAL TOTAL PRICE"]
[null,"13.      ","Bill Review",8000,null,12,{"$f":"(F35*E35)*D35","v":0}]
[null,"$3,000,000 annual fee scheduled invoices x average discount x % of savings",{"$nulls":4},{"$f":"SUM(G35)","v":0}]
[]
[null,"Property Adjusting Fees"]
[null,"ITEM NO.","DESCRIPTION","ESTIMATED QUANTITY","PRICE PER MONTH"," x12","ANNUAL TOTAL PRICE"]
[null,"14.      ","Automobile Property Damage Appraisals",50,null,12,{"$f":"(F40*E40)*D40","v":0}]
[null,"15.      ","Non-Automobile Property Damage Appraisals",25,null,12,0]
[null,"Subtotal of lines 13 through 15",{"$nulls":4},{"$f":"SUM(G40:G41)","v":0}]
[null,"Total lines 1 through 15",{"$nulls":4},{"$f":"G12+G21+G29+G36+G42","v":0}]
[]
[null,null,"Per Claim Cost"]
[null,null,"Takeover Claims:","Estimated # Claims","Per Claim Cost","Subtotal"]
[null,null,"Workers Comp Indemnity",20,null,{"$f":"E47*D47","v":{"v":0,"d":"$0"}}]
[null,null,"Workers Comp Medical Only",20,null,{"$f":"E48*D48","v":{"v":0,"d":"$0"}}]
[null,null,"Workers Comp Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical ( 1st Party)",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical ( 1st Party)Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Property claims < $50K",20,null,{"v":0,"d":"$0"}]
[null,null,"Total",{"$f":"SUM(D47:D56)","v":200},null,{"$f":"SUM(F47:F56)","v":{"v":0,"d":"$0"}}]
[]
[null,null,"Life of Contract:","# Claims","Per Claim Cost","Subtotal"]
[]
[null,null,"Workers Comp Indemnity",20,null,{"$f":"E61*D61","v":{"v":0,"d":"$0"}}]
[null,null,"Workers Comp Medical Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Workers Comp Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical (1st Party)",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical (1st Party)Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Property claims < $50K",20,null,{"v":0,"d":"$0"}]
[null,null,"Total",{"$f":"SUM(D61:D70)","v":200},null,{"$f":"SUM(F61:F70)","v":{"v":0,"d":"$0"}}]
[]
[null,null,"Cradle to Grave:","# Claims","Per Claim Cost","Subtotal"]
[]
[null,null,"Workers Comp Indemnity",20,null,{"$f":"E75*D75","v":{"v":0,"d":"$0"}}]
[null,null,"Workers Comp Medical Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Workers Comp Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical (1st Party)",20,null,{"v":0,"d":"$0"}]
[null,null,"Auto Physical (1st Party) Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability",20,null,{"v":0,"d":"$0"}]
[null,null,"General Liability Incident Only",20,null,{"v":0,"d":"$0"}]
[null,null,"Property claims < $50K",20,null,{"v":0,"d":"$0"}]
[null,null,"Total",{"$f":"SUM(D75:D84)","v":200},null,{"$f":"SUM(F75:F84)","v":{"v":0,"d":"$0"}}]