00 42 14 Form of Proposal.pdf

Addendum 2, May 9, 2025 1 of 6

F O R M OF P R O P O S A L

GRANVILLE HEALTH SYSTEM

Project

MRI, CT, and Nuclear Imaging Renovations

1010 College St., Oxford, NC 27565

Date (Bidder to Enter):

Bidder: Name: ____________________________________

Address: ____________________________________

Telephone: ____________________________________

The undersigned, as bidder, hereby declares that the only person or persons interested in this proposal as principal or principals is or are named herein and that no other person than herein mentioned has any interest in this proposal or in the contract to be entered into; that this proposal is made without connection with any other person, company or parties making a bid or proposal; and that it is in all respects fair and in good faith without collusion or fraud. The bidder further declares that he has examined the site of the work and the contract documents relative thereto, and has read all special provisions furnished prior to the opening of bids; that he has satisfied himself relative to the work to be performed. The bidder further declares that he and his subcontractors have fully complied with NCGS 64, Article 2 in regards to E- Verification as required by Section 2.(c) of Session Law 2013-418, codified as N.C. Gen. Stat. § 143- 129(j).

The Bidder proposes and agrees if this proposal is accepted to contract with GRANVILLE HEALTH

SYSTEM in the form of contract specified below, to furnish all necessary materials, equipment, machinery, tools, apparatus, means of transportation and labor necessary to complete the construction of “MRI, CT, and Nuclear Imaging Renovations at Granville Medical Center located in Oxford, North

Carolina” in full in complete accordance with the plans, specifications and contract documents, to the full and entire satisfaction of the GRANVILLE HEALTH SYSTEM, and the with a definite understanding that no money will be allowed for extra work except as set forth in the General Conditions and the contract documents, for the sum of:

SINGLE PRIME CONTRACT:

Base Bid:

Dollars($)

COST BREAK-OUT

A. Fixed General Conditions: $ ____________________________________________________

B. General Requirements/Permits: $ _______________________________________________

C. Demolition: $ _______________________________________________________________

Addendum 2, May 9, 2025 2 of 6

D. Concrete: $ _________________________________________________________________

E. Structural and Miscellaneous Steel: $ ____________________________________________

F. Equipment Supports: $ ________________________________________________________

G. Finish Carpentry and Architectural Woodwork: $ ____________________________________

H. Roofing: $ __________________________________________________________________

I. Fireproofing: $ ______________________________________________________________

J. Firestopping: $ ______________________________________________________________

K. Doors/Frames/Hardware: $ ____________________________________________________

L. Glazing: $ __________________________________________________________________

M. Metal-Stud Framing and Gypsum Board: $ ________________________________________

N. Acoustical Ceiling: $ __________________________________________________________

O. Flooring: $ _________________________________________________________________

P. Painting: $ _________________________________________________________________

Q. Specialties: $ _______________________________________________________________

R. Fire Suppression: $ __________________________________________________________

S. Plumbing/HVAC: $ ___________________________________________________________

T. Test and Balance: $ __________________________________________________________

U. Electrical: $ _________________________________________________________________

CONTRACT TIME:

If this Bid is accepted, we will substantially complete the Work by the in ____________________ work days from Notice to Proceed.

UNIT PRICES:

The following unit price classification as defined in the contract documents and further described in the appropriate related technical specifications:

Item Description Unit Quantity Unit Price Item Value

Moisture Mitigation

Square Footage of

All Concrete Floor Slabs

(included in stipulated sum)

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ALTERNATES:

The following amounts shall be added to or deducted from the Bid Amount.

1. Alternate No. 01 - Provide a modular RF-shielded MRI enclosure:

(Add) (Deduct)

$ ________________________________________Dollars ($___________________)

Alternate as priced shall have NO effect on project completion time.

2. Alternate No. 02 - Provide backlit images on the lenses of three 24- by 48-inch light fixtures polycarbonate panels dropped into the suspended ceiling grid, illuminated by 1/2-inch deep LED panels in each of three imaging rooms:

3. Alternate No. 03 - Provide three additional 24- by 48-inch light fixtures that have translucent film in each of three imaging rooms:

General Subcontractor: Plumbing Subcontractor:

Mechanical Subcontractor: Electrical Subcontractor:

Upon award of the contract, the awarded bidder shall commence work to be performed on a date to be specified in a written order of GHS and shall fully complete all work hereunder within 190 consecutive calendar days from said date. For each day in excess of thereof, liquidated damages shall be assessed at the rate of $1000.00 per day if the work is not completed by the date specified.

G.S. 143-128(d) requires all single prime bidders to identify their subcontractors for the above subdivisions of work. A contractor whose bid is accepted shall not substitute any person as subcontractor

Addendum 2, May 9, 2025 4 of 6 in the place of the subcontractor listed in the original bid, except (i) if the listed subcontractor's bid is later determined by the contractor to be non-responsible or non-responsive or the listed subcontractor refuses to enter into a contract for the complete performance of the bid work, or (ii) with the approval of the awarding authority for good cause shown by the contractor.

MINORITY BUSINESS PARTICIPATION REQUIREMENTS

Provide with the bid - Under GS 143-128.2(c) the undersigned bidder shall identify on its bid (Identification of Minority Business Participation Form) the minority businesses that it will use on the project with the total dollar value of the bids that will be performed by the minority businesses. Also list the good faith efforts (Affidavit A) made to solicit minority participation in the bid effort.

NOTE: A contractor that performs all of the work with its own workforce may submit an Affidavit

(B) to that effect in lieu of Affidavit (A) required above. The MB Participation Form must still be submitted even if there is zero participation.

After the bid opening - The Owner will consider all bids and alternates and determine the lowest responsible, responsive bidder. Upon notification of being the apparent low bidder, the bidder shall then file within 72 hours of the notification of being the apparent lowest bidder, the following:

An Affidavit (C) that includes a description of the portion of work to be executed by minority businesses, expressed as a percentage of the total contract price, which is equal to or more than the 10% goal established. This affidavit shall give rise to the presumption that the bidder has made the required good faith effort and Affidavit D is not necessary;

* OR *

If less than the 10% goal, Affidavit (D) of its good faith effort to meet the goal shall be provided. The document must include evidence of all good faith efforts that were implemented, including any advertisements, solicitations and other specific actions demonstrating recruitment and selection of minority businesses for participation in the contract.

Note: Bidders must always submit with their bid the Identification of Minority Business Participation Form listing all MB contractors, vendors and suppliers that will be used. If there is no MB participation, then enter none or zero on the form. Affidavit A or Affidavit B, as applicable, also must be submitted with the bid. Failure to file a required affidavit or documentation with the bid or after being notified apparent low bidder is grounds for rejection of the bid.

Addendum 2, May 9, 2025 5 of 6

Proposal Signature Page

The undersigned further agrees that in the case of failure on his part to execute the said contract and the bonds within ten (10) consecutive calendar days after being given written notice of the award of contract, the certified check, cash or bid bond accompanying this bid shall be paid into the funds of the owner's account set aside for the project, as liquidated damages for such failure; otherwise the certified check, cash or bid bond accompanying this proposal shall be returned to the undersigned.

Respectfully submitted this day of

(Name of firm or corporation making bid)

WITNESS: By:

Signature

Name:

(Proprietorship or Partnership) Print or type

Title______________ (Owner/Partner/Pres./V..Pres.)

Address

ATTEST:

By: License No.

Title: Federal I.D. No.

(Corp. Sec. or Asst. Sec. only)

Email Address:

(CORPORATE SEAL)

Addendum received and used in computing bid:

Addendum No. 1 Addendum No. 3 Addendum No. 5 Addendum No. 7

Addendum No. 2 Addendum No. 4 Addendum No. 6 Addendum No. 8

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