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Fillable Printable VA Form 10-6298

Fillable Printable VA Form 10-6298

VA Form 10-6298

VA Form 10-6298

OMB Number 2900-0208
Estimated Burden: 4 hours
-
A/E
I
/
-
1A
$
1B
1C
$$
1D
1E
1F
1G
1H
1I
ARCHITECTURAL
3A
3B
3C
4D
2D
2A
2B
2C
2E
2F
2G
2H
2I
3D
3E
3F
3G
3H
3I
4A
SANITARY
4B
4C
4E
4F
4G
4H
4I
ARCHITECTENGINEERFEE PROPOSAL
ThePaperworkReductionActof1995
requiresustonotifyyouthatthisinformationcollectionisinaccordancewiththeclearancerequirementsofsection3507ofthePaperworkReductionActf
1995.Wemaynotconductorsponsor,andyouarenotrequiredtorespondto,acollectionofinformationunlessitdisplaysavalidOMBnumber.Weanticipatethatthetimeexpendedbyall
individualswhomustcompletethisformwillaverage4hours.Thisincludesthetimeitwilltaketoreadinstructions,gatherthenecessaryfactsandfill outtheform.Thisformorotheragreedupon
format, is used by VA Resident Engineers to supervise your work andverify the work progression so that you may be paid.
ESTIMATED NUMBEROF CONTRACT DRAWINGS
DESCRIPTIONVA
ARCHITECTURAL
SITE ANDLANDSCAPING
STRUCTURAL ANDBORINGS
SAN TARY
PLUM BING
HEATINGANDAIR CONDITIONING
ELECTRICA L
TOTAL NUMBER OFDRAWINGS
DATEOF PROPOSAL
PROJ ECT
NAME OFARCHITECT ENGINEER
PARTIPREPARATIONOF CONTRACT DRAWINGSANDSPECIFICATIONS
LINE
NO.
A.SALARY COSTS
EM PLOYEE HOURS
A/EVA
HOURLY
SALARIES
COSTS
A/EVA
SUPERVISORS
DESIGNERS
STRUCTURAL AND BORINGS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
DESIGNERS
DRAFTERS
TYPISTS
SUB-TOTAL
SUB-TOTAL
SUPERVISORS
SITE AND LANDSCAPING
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
SUB-TOTAL
SUPERVISORS
SPECIFICATION WRITERS
ESTIMATORS
SUB-TOTAL
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
TYPISTS
ESTIMATORS
VA
FORM
JAN1999 (R)
10-6298
PA GE 1OF9
PARTI- PREPARATIONOF CONTRACT DRAWINGS ANDSPECIFICATIONS
(Continued)
LINE
NO.
A.SALARY COSTS
EM PLOY EEHOURS
HOURLY
SALARIES
COSTS
A/EVAA/EVA
5A
PLUMBING
SUPERVISORS
$$$
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.MISCELLANEOUSSALARY COSTS
11A
DESIGNREVIEWTRIPS
EM PLOY EE-DAYSEM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
NO.REQUIRED#DAYS#PERS.REQUIRED
A/EVAA/EVAA/EVA
11B
SUPERVISORS
11C
DESIGNERS
11D
DRAFTERS
11E
SPEC.WRITERS
VA
FORM
PA GE 2OF9
JAN1999 (R)
10-6298
B.MISCELLANEOUS SALARYCOSTS
(Continued)
DESIGNREVIEWTRIPS
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/EVAA/EVA
SUB-TOTAL
DESIGNERS
DRAFTERS
SPEC.W RITERS
TYPISTS
NO.REQUIRED
FIRST
DESIGNSTAFF 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
ANSWERINGINQ.&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/EVA
EM P. TRIPS
A/EVAA/E
TRAVELCOSTS
VA
20F
19
20A
20B
20C
20D
20E
SECOND
SUPERVISORS
DESIGNERS
THIRD
SUB-TOTAL
$$$$
DESIGNREVIEWTRIPS
NO.REQUIRED
20G
22A
22B
22C
22D
22E
DESIGNERS
SUPERVISORS
SUB-TOTAL
SUB-TOTAL
DESIGNERS
NO.REQUIRED
SUPERVISORS
21F
DESIGNSTAFF SITE TRIPS
21A
21B
21C
21D
21E
$
$
$
A/E
A/E
COSTS
$
COSTS
$
VA
VA
VA
FORM
JAN1999 (R)
10-6298
PA GE 3OF9
C.INCIDENTALCOSTS
(Continued)
SUB-TOTAL
A/E
EM P. DAYSCOSTS
31
TOTAL INCIDENTAL COSTS
LINE
NO.
PER DIEM
VAA/EVAA/EVA
EM P. TRIPS
A/EVAA/E
TRAVELCOSTS
VA
26F
26A
26B
26C
26D
26E
*TOTAL PROPOSAL (LINE 19 + LINE 30)
29A
29B
29C
29D
29E
SUB-TOTAL
SUB-TOTAL
27F
27A
27B
27C
27D
27E
29F
*NOTE:This part of the fee is that which falls within the 6% limitation.See VAAR Section 836.606-73 fordefinitiveinformation.
REMARKS
SUB-TOTAL
28F
28A
28B
28C
28D
28E
SUB-TOTAL
25F
$
23F
23A
23B
23C
23D
23E
$$$$
$
25A
25B
25C
25D
25E
SUB-TOTAL
SUB-TOTAL
24F
24A
24B
24C
24D
24E
RENDERING(PERSPECTIVES)
REPRODUCTIONOF REVIEW MATERIAL
NO.REQUIRED
30
$
$
$
$
VA
FORM
PA GE 4OF 9
JAN1999 (R)
10-6298
32A
VA
32G
32D
32F
ELECTRICAL
$
ARCHITECTURAL
$$
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- CONSTRUCTIONPERIODSERVICES
A.SHOPDRAWINGS,SUBMITTALS,ETC.,
SALARY COSTS
32B
EM PLOY EE-HOURS
HOURLY
SALARIES
A/E
SUB-TOTAL
32C
LINE
NO.
A/EVA
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 5OF 9
JAN1999 (R)
10-6298
PART II- CONSTRUCTIONPERIODSERVICES
LINE
NO.
A.SHOPDRAWINGS,SUBMITTALS,ETC.,
SALARY COSTS(
Continued)
EM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
A/EVAA/EVA
39A
$$$
39B
39C
39D
39E
39F
39G
SUB-TOTAL
40A
40B
40C
40D
40E
40F
40G
SUB-TOTAL
41
TOTAL SALARY COSTS
LINE
NO.
B.RECORD(ASBUILT) DRAWINGSANDSPECIFICATIONS
SALARY COSTS
EM PLOY EE-HOURS
HOURLY
SALARIES
COSTS
A/EVAA/EVA
42A
ARCHITECTURAL
$$$
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 6OF 9
JAN1999 (R)
10-6298
47A
48A
47G
47D
47F
48D
48F
60
58A
$$$
51
52
58D
ELECTRICAL
50A
50D
50F
53
54
55
56A
56D
(
49A
49D
49F
A/EVAA/EVA
$$$$$$
()
()
57A
57D
59
REMARKS
(
47B
47C
48B
48C
PART II- CONSTRUCTIONPERIODSERVICES
47E
48E
58B
58C
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
50B
50C
50E
C.INCIDENTAL COSTS
EM PLOY EE-HOURS
HOURLY
SALARIES
A/EVA
LINE
NO.
A/EVA
COSTS
56E
56B
56C
57E
TOTAL PROPOSAL
Lines 55 + 59)
HEATING AND AIR CONDITIONING
SUPERVISORS
DESIGNERS
DRAFTERS
SPECIFICATION WRITERS
SUB-TOTAL
49B
49C
49E
SUB-TOTAL
SUB-TOTAL
TOTAL LABOR PROPOSAL
(Lines 52 + 53 + 54)
A/E
EM P. DAYSCOSTS
PER DIEM
VAA/EVA
EM P. TRIPS
A/EVA
TRAVELCOSTS
SUB-TOTAL
B.RECORDASBUILT DRAWINGSANDSPECIFICATIONS
SALARY COSTS
Continued
57B
57C
SUB-TOTAL
SUB-TOTAL
58E
SUB-TOTAL
TOTAL TRAVEL COSTS
TOTAL SALARY COSTS
OVERHEAD
PROFIT
TOTAL SALARY COSTS
Lines 41 + 51)
VA
FORM
PA GE 7OF 9
JAN1999 (R)
10-6298
I-I
VA
66D
66A
I
-
II
61F
/
66F
62
63
64
65
)
67
I
61D
61A
I
-
II
/
A/E
(
(
/
(
68
69
70
71
72
(
)
-II
$$
$$
$$
$$
Title
PART IISITE V SITS
EM P. DAYS
A/E
COSTS
A/EVA
PER DIEM
66E
A.TRAVELCOSTS
PRE-CONSTRUCTIONCONFERENCE
NO.VISITSNO.DAYSEMP. PERDAY
SITE V SITS
NO.VISITS,ONE EMPLOYEE DAYEACH
66B
FINALNSPECT ON
NO.DAYSEMPLOYEESPERDAY
INTERMEDIATE A C INSPECTIONS
NO.INSP.NO.DAYEACHEMP. PER DAY
66C
TOTAL SALARY COSTS
(Lines 62 + 63 + 64
OVERHEAD% OF LINE 62
PROFIT
EM PLOYEE TR PS
A/EVA
HOURLY
SALARIES
COSTS
A/EVA
TOTAL HOURS
A/EVA
A.SALARYCOSTS
LINE
NO.
PRE-CONSTRUCTIONCONFERENCE
NO.VISITSNO.DAYSEMP. PERDAY
SITE V SITS
NO.VISITSONE EMPLOYEE DAYEACH
61B
FINALNSPECT ON
NO.DAYSEMPLOYEESPERDAY
INTERMEDIATE A C INSPECTIONS
NO.INSP.NO.DAYEACHEMP. PER DAY
61C
61E
TRAVELCOSTS
A/EVAA/EVAVA
EM P. TRIPS
SALARY COSTS:SITE VISITS
TOTAL PROPOSAL FORSITE VISITS
Lines 65 + 67)
TOTAL A/E PROPOSAL
Lines 31 + 60 + 68)
PARTIV- CAPITULATIONOF 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 the6% limit
ation.SeeVAARSection836.606-73fordefinitiveinformation.
PARTVCERTIF CAT ONS
Thisistocertifythat,tothebestofmyknowledgeandbelief,thecostorpricingdata(asdefinedinsection15.801oftheFederalAcquisitionRegulation(FAR)andrequiredunderFAR
subsection15.804-2submitted,eitheractuallyorbyspecificidentificationinwritingtothecontractingofficerortothecontractingofficer'srepresentativeinsupportof.....areaccurate,
complete,andcurrents of......Thiscertificationincludesthecost or pricingdatasupportinganyadvanceagreementsetweenhe offeror andtheGovernmentthat are part of the proposal.
CERTIFICATION OF CURRENT COST OR PRICINGDATA
Firm
Signature
Name
DateofExecution
VA
FORM
PA GE 8OF9
JAN1999 (R)
10-6298
ifiilicabliif
ii
-
(
)(
I
--
--
--
--
/
NOTE:TheArchitect-Engineershall checkthecertcationbelowwhichsappetotheirenterpr se, andrequired,providethenecessary
substantiat nginformat on.
Theofferorherebycertifiesthat,togetherwithalldivisions,subsidiaries,andaffiliatesundercommoncontrol,theydidnot(1)receiveasingleCAS-coveredcontract
award if$10 millionormore; (2)Receive $10million ormore inCAS-covered contractawards duringitspreceding accountingperiod;(3) Receivelessthan $10million
in CAS-covered contract awards during its precedingcostaccountingperiod but such awards were 10 percent ormore of total sales.
DATE OFDISCLOSURE STATEMENTNAME ANDADDRESS OFCOGNIZANTCONTRACTINGOFFICERSWHERE FILED
The offeror further certifiesthat practices used inestimating costs in pricing this proposalare consistent with the costaccounting practices in the Disclosure Statements.
CONCURSIGNATURE ANDTYPED NAME OFCONTRACTINGOFFICER
CERTIFICATIONOF CONCURRENTSUBMISSIONOF DISCLOSURE STATEMENTS
CERTIFICATIONOF PREVIOUSLYSUBMITTEDDISCLOSURE STATEMENTS
Theofferorherebycertifiessubmission,aspartoftheproposalunder thissolicitation,copiesoftheDisclosureStatementsasfollows:i)Originalandonecopy
tothecognizant ContractingOfficer;(ii onecopy tothecognizantcontractauditor;andiii)onecopytotheCostAccountingStandardsBoard,441G.Street,
NW, Washington, DC20548
NAMEANDADDRESSOF COGNIZANTCONTRACTINGOFFICERSWHERE FILED
CERTIFICATIONOF MONETARYEXEMPTION
The offeror hereby certifiesthat practices used inestimating costs in pricing this proposal are consistent with thecost accounting practices disclosed inthis Disclosure Statement
DATE OFD SCLOSURE STATEMENT
The offeror hereby certifiesthat the Disclosure Statements were filedas follows:
DATE
DATE
DATE
DATE
DATE
CONCURSIGNA TURE A NDTYPEDNA M E OFA RCHITECTENGINEER
CONCURSIGNA TURE A NDTYPEDNA M E OFA RCHITECTENGINEER
CONCURSIGNA TURE A NDTYPEDNA M E OFA RCHITECTENGINEER
CONCURSIGNA TURE A NDTYPEDNA M E OFA RCHITECTENGINEER
DISTRIBUTION:(082A)-CC:AEandProposedFile
VA
FORM
PA GE 9OF9
JAN1999 (R)
10-6298
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