Fillable Printable VA Form 10-6298
Fillable Printable VA Form 10-6298
VA Form 10-6298
OMB Number 2900-0208
Estimated Burden: 4 hours
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ARCHITECTURAL
3A
3B
3C
4D
2D
2A
2B
2C
2E
2F
2G
2H
2I
3D
3E
3F
3G
3H
3I
4A
SANITARY
4B
4C
4E
4F
4G
4H
4I
ARCHITECT ENGINEER FEE PROPOSAL
The Paperwork Reduction Act of 1995
requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork ReductionAct f
1995. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all
individuals who must complete this form will average 4 hours. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. This form or other agreed upon
format, is used by VA Resident Engineers to supervise your work and verify the work progression so that you may be paid.
ESTIMATED NUMBER OF CONTRACT DRAWINGS
DESCRIPTION VA
ARCHITECTURAL
SITE AND LANDSCAPING
STRUCTURAL AND BORINGS
SAN TARY
PLUM BING
HEATING AND AIR CONDITIONING
ELECTRICA L
TOTAL NUMBER OF DRAWINGS
DATE OF PROPOSAL
PROJ ECT
NAME OF ARCHITECT ENGINEER
PART I PREPARATIONOF CONTRACT DRAWINGS AND SPECIFICATIONS
LINE
NO.
A. SALARY COSTS
EM PLOYEE HOURS
A/E VA
HOURLY
SALARIES
COSTS
A/E VA
SUPERVISORS
DESIGNERS
STRUCTURAL AND BORINGS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
DESIGNERS
DRAFTERS
TYPISTS
SUB-TOTAL
SUB-TOTAL
SUPERVISORS
SITE AND LANDSCAPING
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
SUB-TOTAL
SUPERVISORS
SPECIFICATION WRITERS
ESTIMATORS
SUB-TOTAL
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
VA
FORM
JAN 1999 (R)
10-6298
PA GE 1 OF 9
PART I - PREPARATIONOF CONTRACT DRAWINGS AND SPECIFICATIONS
(Continued)
LINE
NO.
A. SALARY COSTS
EM PLOY EEHOURS
HOURLY
SALARIES
COSTS
A/E VA A/E VA
5A
PLUMBING
SUPERVISORS
$ $ $
5B
DESIGNERS
5C
DRAFTERS
5D
SPECIFICATION WRITERS
5E
TYPISTS
5F
ESTIMATORS
5G
5H
5I
SUB-TOTAL
6A
HEATING AND AIR CONDITIONING
SUPERVISORS
6B
DESIGNERS
6C
DRAFTERS
6D
SPECIFICATION WRITERS
6E
TYPISTS
6F
ESTIMATORS
6G
6H
6I
SUB-TOTAL
7A
ELECTRICAL
SUPERVISORS
7B
DESIGNERS
7C
DRAFTERS
7D
SPECIFICATION WRITERS
7E
TYPISTS
7F
ESTIMATORS
7G
7H
SUB-TOTAL
8A
8B
8C
8D
8E
8F
8G
8H
8I
SUB-TOTAL
9A
9B
9C
9D
9E
9F
9G
9H
9I
SUB-TOTAL
10
TOTAL SALARY COSTS
B. MISCELLANEOUS SALARY COSTS
11A
DESIGN REVIEW TRIPS
EM PLOY EE-DAYS EM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
NO. REQUIRED # DAYS # PERS. REQUIRED
A/E VA A/E VA A/E VA
11B
SUPERVISORS
11C
DESIGNERS
11D
DRAFTERS
11E
SPEC. WRITERS
VA
FORM
PA GE 2 OF 9
JAN 1999 (R)
10-6298
B. MISCELLANEOUS SALARY COSTS
(Continued)
DESIGN REVIEW TRIPS
SUB-TOTAL
TOTAL SALARY COSTS -
(Lines 10 + 15)
#DAYS # ERS. REQUIRED
11F
11G
PROFIT
EM PLOY EE-DAYS
A/E
EM P. DAYS
EM PLOY EE-HOURS
HOURLY
SALARIES
A/E VA A/E VA
SUB-TOTAL
DESIGNERS
DRAFTERS
SPEC. W RITERS
TYPISTS
NO. REQUIRED
FIRST
DESIGN STAFF SITE TRIPS
FOURTH
NO. REQUIRED
SUB-TOTAL
C. INCIDENTAL COSTS
SUPERVISORS
PRE-BID(CPM) CONFERENCE
DESIGNERS
NO. REQUIRED
SUB-TOTAL
TOTAL SALARY PROPOSALS-
(Lines 16 + 17
TOTAL MISCELLANEOUSSALARY COSTS
OVERHEAD: % OF LINE 16
11H
12F
12A
12B
12C
12D
12E
17
13B
13A
13C
13D
13E
13F
14B
SUPERVISORS
ANSWERING INQ. & ISSUING AMENDMENTS
14A
14C
14D
14E
14F
14G
14H
15
16
18
22F
PRE-BID(CPM) CONFERENCE
LINE
NO.
LINE
NO.
PER DIEM
#DAYS # ERS. REQUIREDNO. REQUIRED
VAA/E VA
EM P. TRIPS
A/E VA A/E
TRAVEL COSTS
VA
20F
19
20A
20B
20C
20D
20E
SECOND
SUPERVISORS
DESIGNERS
THIRD
SUB-TOTAL
$ $ $ $
DESIGN REVIEW TRIPS
NO. REQUIRED
20G
22A
22B
22C
22D
22E
DESIGNERS
SUPERVISORS
SUB-TOTAL
SUB-TOTAL
DESIGNERS
NO. REQUIRED
SUPERVISORS
21F
DESIGN STAFF SITE TRIPS
21A
21B
21C
21D
21E
$
$
$
A/E
A/E
COSTS
$
COSTS
$
VA
VA
VA
FORM
JAN 1999 (R)
10-6298
PA GE 3 OF 9
C. INCIDENTAL COSTS
(Continued)
SUB-TOTAL
A/E
EM P. DAYS COSTS
31
TOTAL INCIDENTAL COSTS
LINE
NO.
PER DIEM
VA A/E VAA/E VA
EM P. TRIPS
A/E VA A/E
TRAVEL COSTS
VA
26F
26A
26B
26C
26D
26E
*TOTAL PROPOSAL (LINE 19 + LINE 30)
29A
29B
29C
29D
29E
SUB-TOTAL
SUB-TOTAL
27F
27A
27B
27C
27D
27E
29F
*NOTE: This part of the fee is that which falls within the 6% limitation. See VAAR Section 836.606-73 for definitive information.
REMARKS
SUB-TOTAL
28F
28A
28B
28C
28D
28E
SUB-TOTAL
25F
$
23F
23A
23B
23C
23D
23E
$ $ $ $
$
25A
25B
25C
25D
25E
SUB-TOTAL
SUB-TOTAL
24F
24A
24B
24C
24D
24E
RENDERING(PERSPECTIVES)
REPRODUCTION OF REVIEW MATERIAL
NO. REQUIRED
30
$
$
$
$
VA
FORM
PA GE 4 OF 9
JAN 1999 (R)
10-6298
32A
VA
32G
32D
32F
ELECTRICAL
$
ARCHITECTURAL
$$
32H
38A
38D
38F
38G
TYPISTS
TYPISTS
33A
33D
33F
33G
33H
34A
34D
34F
34G
SANITARY
35A
35D
35F
35G
36A
36D
36F
36G
37A
37D
37F
37G
PART II - CONSTRUCTION PERIOD SERVICES
A. SHOP DRAWINGS, SUBMITTALS, ETC.,
SALARY COSTS
32B
EM PLOY EE-HOURS
HOURLY
SALARIES
A/E
SUB-TOTAL
32C
LINE
NO.
A/E VA
COSTS
32E
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
SUB-TOTAL
38B
38C
38E
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
SUB-TOTAL
SITE AND LANDSCAPING
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
33B
33C
33E
SUB-TOTAL
STRUCTURAL AND BORINGS
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
34B
34C
34E
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
SUB-TOTAL
ESTIMATORS
35B
35C
35E
SUB-TOTAL
PLUMBING
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
36B
36C
36E
SUB-TOTAL
HEATING AND AIRCONDITIONING
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
ESTIMATORS
37B
37C
37E
VA
FORM
PA GE 5 OF 9
JAN 1999 (R)
10-6298
PART II - CONSTRUCTION PERIOD SERVICES
LINE
NO.
A. SHOP DRAWINGS, SUBMITTALS, ETC.,
SALARY COSTS (
Continued)
EM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
A/E VA A/E VA
39A
$ $ $
39B
39C
39D
39E
39F
39G
SUB-TOTAL
40A
40B
40C
40D
40E
40F
40G
SUB-TOTAL
41
TOTAL SALARY COSTS
LINE
NO.
B. RECORD (AS BUILT) DRAWINGS AND SPECIFICATIONS
SALARY COSTS
EM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
A/E VA A/E VA
42A
ARCHITECTURAL
$ $ $
SUPERVISORS
42B
DESIGNERS
42C
DRAFTERS
42D
SPECIFICATION WRITERS
42E
42F
42G
SUB-TOTAL
43A
SITE AND LANDSCAPING
SUPERVISORS
43B
DESIGNERS
43C
DRAFTERS
43D
SPECIFICATION WRITERS
43E
43F
43G
SUB-TOTAL
44A
STRUCTURAL AND BORINGS
SUPERVISORS
44B
DESIGNERS
44C
DRAFTERS
44D
SPECIFICATION WRITERS
44E
44F
44G
SUB-TOTAL
45A
SANITARY
SUPERVISORS
45B
DESIGNERS
45C
DRAFTERS
45D
SPECIFICATION WRITERS
45E
45F
45G
SUB-TOTAL
46A
PLUMBING
SUPERVISORS
46B
DESIGNERS
46C
DRAFTERS
46D
SPECIFICATION WRITERS
46E
46F
SUB-TOTAL
VA
FORM
PA GE 6 OF 9
JAN 1999 (R)
10-6298
47A
48A
47G
47D
47F
48D
48F
60
58A
$$$
51
52
58D
ELECTRICAL
50A
50D
50F
53
54
55
56A
56D
(
49A
49D
49F
A/E VA A/EVA
$$ $ $ $ $
( )
( )
57A
57D
59
REMARKS
(
47B
47C
48B
48C
PART II - CONSTRUCTION PERIOD SERVICES
47E
48E
58B
58C
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
50B
50C
50E
C. INCIDENTAL COSTS
EM PLOY EE-HOURS
HOURLY
SALARIES
A/E VA
LINE
NO.
A/E VA
COSTS
56E
56B
56C
57E
TOTAL PROPOSAL
Lines 55 + 59)
HEATING AND AIR CONDITIONING
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
SUB-TOTAL
49B
49C
49E
SUB-TOTAL
SUB-TOTAL
TOTAL LABOR PROPOSAL
(Lines 52 + 53 + 54)
A/E
EM P. DAYS COSTS
PER DIEM
VAA/E VA
EM P. TRIPS
A/E VA
TRAVEL COSTS
SUB-TOTAL
B. RECORD AS BUILT DRAWINGS AND SPECIFICATIONS
SALARY COSTS
Continued
57B
57C
SUB-TOTAL
SUB-TOTAL
58E
SUB-TOTAL
TOTAL TRAVEL COSTS
TOTAL SALARY COSTS
OVERHEAD
PROFIT
TOTAL SALARY COSTS
Lines 41 + 51)
VA
FORM
PA GE 7 OF 9
JAN 1999 (R)
10-6298
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66A
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62
63
64
65
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67
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61D
61A
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68
69
70
71
72
(
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$ $
$ $
$ $
$ $
Tit le
PART II SITE V SITS
EM P. DAYS
A/E
COSTS
A/E VA
PER DIEM
66E
A. TRAVEL COSTS
PRE-CONSTRUCTION CONFERENCE
NO. VISITS NO. DAYS EMP. PERDAY
SITE V SITS
NO. VISITS, ONE EMPLOYEE DAY EACH
66B
FINAL NSPECT ON
NO. DAYS EMPLOYEESPERDAY
INTERMEDIATE A C INSPECTIONS
NO. INSP. NO. DAY EACH EMP. PER DAY
66C
TOTAL SALARY COSTS
(Lines 62 + 63 + 64
OVERHEAD % OF LINE 62
PROFIT
EM PLOYEE TR PS
A/E VA
HOURLY
SALARIES
COSTS
A/E VA
TOTAL HOURS
A/E VA
A. SALARY COSTS
LINE
NO.
PRE-CONSTRUCTION CONFERENCE
NO. VISITS NO. DAYS EMP. PERDAY
SITE V SITS
NO. VISITS ONE EMPLOYEE DAY EACH
61B
FINAL NSPECT ON
NO. DAYS EMPLOYEESPERDAY
INTERMEDIATE A C INSPECTIONS
NO. INSP. NO. DAY EACH EMP. PER DAY
61C
61E
TRAVEL COSTS
A/E VAA/E VA VA
EM P. TRIPS
SALARY COSTS: SITE VISITS
TOTAL PROPOSAL FOR SITE VISITS
Lines 65 + 67)
TOTAL A/E PROPOSAL
Lines 31 + 60 + 68)
PART IV - CAPITULATION OF A E PROPOSALS
PART II - CONSTRUCTION PERIOD DUTIES
Line 60)
TOTAL TRAVEL COSTS
*PART I - CONTRACT DRAWINGS AND SPECIFICATIONS
Line 31)
PART III - SITE VISITS, AT $ PER VISIT
FOR A MAXIMUM OF:
(Line 68
*NOTE: This part of the fee is that which falls within the 6% limit
ation. See VAAR Section 836.606-73 for definitive information.
PART V CERTIF CAT ONS
This is to certify that, to the best of my knowledge and belief, the cost or pricing data (as defined in section 15.801 of the Federal Acquisition Regulation (FAR) and required under FAR
subsection 15.804-2 submitted, either actually or by specific identification in writing to the contracting officer or to the contracting officer's representative in support of ..... areaccurate,
complete,andcurrent s of..... . Thiscertificationincludesthe cost or pricingdata supportingany advanceagreements etween he offeror andthe Government that are part of the proposal.
CERTIFICATION OF CURRENT COST OR PRICING DATA
Firm
Signat ure
Name
Date of Execution
VA
FORM
PA GE 8 OF 9
JAN 1999 (R)
10-6298
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NOTE: The Architect-Engineer shall check the cert cation below which s app e to their enterpr se, and required, provide the necessary
substantiat ng informat on.
The offeror hereby certifies that, together with all divisions, subsidiaries, and affiliates under common control, they did not (1) receive a single CAS-covered contract
award if $10 million or more; (2) Receive $10 million or more in CAS-covered contract awards during its preceding accounting period; (3) Receive less than $10 million
in CAS-covered contract awards during its preceding cost accounting period but such awards were 10 percent or more of total sales.
DATE OF DISCLOSURE STATEMENT NAME AND ADDRESS OF COGNIZANT CONTRACTING OFFICERSWHERE FILED
The offeror further certifies that practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices in the Disclosure Statements.
CONCUR SIGNATURE AND TYPED NAME OF CONTRACTING OFFICER
CERTIFICATION OF CONCURRENTSUBMISSION OF DISCLOSURE STATEMENTS
CERTIFICATION OF PREVIOUSLY SUBMITTED DISCLOSURE STATEMENTS
The offeror hereby certifies submission, as part of the proposal under this solicitation, copies of the Disclosure Statements as follows: i) Original and one copy
to the cognizant Contracting Officer; (ii one copy to the cognizant contract auditor; and iii) one copy to the Cost Accounting Standards Board, 441 G.Street,
NW, Washington, DC 20548
NAME AND ADDRESS OF COGNIZANT CONTRACTING OFFICERSWHERE FILED
CERTIFICATION OF MONETARY EXEMPTION
The offeror hereby certifies that practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in this Disclosure Statement
DATE OF D SCLOSURE STATEMENT
The offeror hereby certifies that the Disclosure Statements were filed as follows:
DATE
DATE
DATE
DATE
DATE
CONCUR SIGNA TURE A ND TYPED NA M E OF A RCHITECT ENGINEER
CONCUR SIGNA TURE A ND TYPED NA M E OF A RCHITECT ENGINEER
CONCUR SIGNA TURE A ND TYPED NA M E OF A RCHITECT ENGINEER
CONCUR SIGNA TURE A ND TYPED NA M E OF A RCHITECT ENGINEER
DISTRIBUTION:(082A)-CC: AEand ProposedFile
VA
FORM
PA GE 9 OF 9
JAN 1999 (R)
10-6298
