03-0706_DR_815_Form.pdf

STATE OF CALIFORNIA DEPARTMENT OF REHABILITATION

REQUEST FOR QUOTE

RFQ NUMBER: QUOTE DUE DATE: TIME DUE:

DOR CONTACT: PHONE: FAX:

E-MAIL: @DOR.CA.GOV

Line Qty Description

Unique Circumstances:

It is unlawful for any person engaged in business within this state to sell or use any article or product as a "loss leader" as defined in Section 17030 of the Business and Professions Code.

Award will be made based on lowest cost unless unique circumstances dictate otherwise. Bid quotes will be accepted by U.S. Mail, E-mail, or FAX. Your bid quote must include the RFQ number and all information requested. FAX bid quotes will be considered only if they are sent to fax number listed above. Bid quotes sent to any other fax number or DOR Contact will not be considered. To be considered, all pages of the faxed bid quote that are received prior to the bid opening time specified in the bid will be considered “the complete bid”. Please be advised that there is a heavy demand placed on the fax machine receiving bids and the State assumes no responsibility if a supplier cannot transmit the bid via fax or if the entire bid is not received prior to the bid opening time.

The current State of California Bidder Instructions (GSPD-451) applies to this solicitation. The GSPD-451 is available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/ModelSolicitation.htm.

The current State of California General Provisions (GSPD-401 non-IT or IT) also applies to this solicitation. The GSPD- 401 is available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/GeneralProvisions.htm.

For Consumer purchases – DOR will make every effort to solicit quotes from small businesses whenever possible.

By submitting a bid quote, you are acknowledging your acceptance of the terms and conditions of the Bidder Instructions and General Provisions

For Administrative purchases – The Small Business preference and DVBE advertising requirements apply to this solicitation. The DVBE Incentive has been waived for this solicitation. The Small Business preference regulations are located at the DGS Procurement Division website at http://www.pd.dgs.ca.gov/smbus/default.htm. The DVBE program requirements are located at the DGS Procurement Division website at:

http://www.documents.dgs.ca.gov/pd/delegations/STD840.doc. The current DVBE incentive and exemption requirements are located at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/dvbe/dvbeincentive.htm.

If for IT goods and/or services, special provisions apply to this solicitation. The IT Special Provisions Modules are available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/ITModules.htm.

The State is required to purchase recycled content products whenever possible. If you can certify the recycled content of your products, please include with your bid quote the verification form available at:

http://www.ciwmb.ca.gov/BuyRecycled/StateAgency/Forms/CIWMB074.pdf.

By submitting a bid quote, you are acknowledging your acceptance of the terms and conditions of the Small Business preference, DVBE advertising requirements, DVBE incentive, Bidder Instructions and General Provisions.

DR 815 (New.09/12) Page 1 of 2 http://www.pd.dgs.ca.gov/modellang/ModelSolicitation.htm� http://www.pd.dgs.ca.gov/modellang/GeneralProvisions.htm� http://www.pd.dgs.ca.gov/smbus/default.htm� http://www.documents.dgs.ca.gov/pd/delegations/STD840.doc� http://www.pd.dgs.ca.gov/dvbe/dvbeincentive.htm� http://www.pd.dgs.ca.gov/modellang/ITModules.htm� http://www.ciwmb.ca.gov/BuyRecycled/StateAgency/Forms/CIWMB074.pdf�

STATE OF CALIFORNIA DEPARTMENT OF REHABILITATION

RFQ NUMBER: DOR CONTACT:

Supplier Name Supplier Address, City/State, Zip Person Contacted Phone Number Fax Number Certified Small/Micro Business Yes # No SM MB DVBE Date Quote Received Date Quote Expires Seller’s Permit Warranty Period Delivery Date Line Qty Description Unit $ Extension 1.

2.

3.

4.

5.

6.

FOB Destination, Freight Prepaid

Price of freight included in cost of commodity – no additional freight charges added by vendor. State does not own goods during shipment.

FOB Destination, Freight Prepay and Add Seller prepays freight and adds cost to the invoice. State accepts responsibility for freight upon delivery. Cost of freight must be noted and added in price extension. If freight costs are $50.00 or more, the vendor must attach a copy of the actual freight bill with the invoice to process payment. Freight costs of $500 or more must be approved by Transportation Management call 916-376-1888 for best rates.

FOB Origin, Freight Collect State accepts ownership responsibility for merchandise at the Seller’s dock and pays freight charges. This is not a suggested method, if used Transportation Management must be called at (916) 376-1888. Cost of freight must be noted and added in price extension.

Subtotal Quote Total Quote (Tax is not an evaluation item, add tax to the purchase order)

PREPARED BY:

PRINT NAME:

DATE:

DR 815 (New.09/12) Page 2 of 2 mhardima Highlight

STATE OF CALIFORNIA DEPARTMENT OF REHABILITATION

DR 815 (New.01/12) Page 1 of 2

RFQ NUMBER:

QUOTE DUE DATE:

TIME DUE:

DOR CONTACT:

PHONE:

FAX:

E-MAIL: @DOR.CA.GOV

“Pursuant to the Section 19150 of the Welfare and Institutions Code, the Department of Rehabilitation is soliciting price quotes for the following items:”

Line

Qty

Description

Unique Circumstances:

It is unlawful for any person engaged in business within this state to sell or use any article or product as a "loss leader" as defined in Section 17030 of the Business and Professions Code.

Award will be made based on lowest cost unless unique circumstances dictate otherwise. Bid quotes will be accepted by US mail, E-mail, or FAX. Your bid quote must include the RFQ number and all information requested. FAX bid quotes will be considered only if they are sent to fax number listed above. Bid quotes sent to any other fax number or DOR Contact will not be considered. To be considered, all pages of the faxed bid quote that are received prior to the bid opening time specified in the bid will be considered “the complete bid”. Please be advised that there is a heavy demand placed on the fax machine receiving bids and the State assumes no responsibility if a supplier cannot transmit the bid via fax or if the entire bid is not received prior to the bid opening time.

The current State of California Bidder Instructions (GSPD-451) applies to this solicitation. The GSPD-451 is available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/ModelSolicitation.htm.

The current State of California General Provisions (GSPD-401 non-IT or IT) also applies to this solicitation. The GSPD-401 is available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/GeneralProvisions.htm.

For Consumer purchases – DOR will make every effort to solicit quotes from small businesses whenever possible.

By submitting a bid quote, you are acknowledging your acceptance of the terms and conditions of the Bidder Instructions and General Provisions

For Administrative purchases – The Small Business preference and DVBE advertising requirements apply to this solicitation. The DVBE Incentive has been waived for this solicitation. The Small Business preference regulations are located at the DGS Procurement Division website at http://www.pd.dgs.ca.gov/smbus/default.htm. The DVBE program requirements are located at the DGS Procurement Division website at: http://www.documents.dgs.ca.gov/pd/delegations/STD840.doc. The current DVBE incentive and exemption requirements are located at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/dvbe/dvbeincentive.htm.

If for IT goods and/or services, special provisions apply to this solicitation. The IT Special Provisions Modules are available at the DGS Procurement Division website at: http://www.pd.dgs.ca.gov/modellang/ITModules.htm.

The State is required to purchase recycled content products whenever possible. If you can certify the recycled content of your products, please include with your bid quote the verification form available at: http://www.ciwmb.ca.gov/BuyRecycled/StateAgency/Forms/CIWMB074.pdf.

By submitting a bid quote, you are acknowledging your acceptance of the terms and conditions of the Small Business preference, DVBE advertising requirements, DVBE incentive, Bidder Instructions and General Provisions.

STATE OF CALIFORNIA DEPARTMENT OF REHABILITATION

DR 815 (New.01/12) Page 2 of 2

RFQ NUMBER:

DOR CONTACT:

Supplier Name

Supplier Address, City/State, Zip

Person Contacted

Phone Number

Fax Number

Certified Small/Micro Business

Yes # No|_|

|_|SM |_|MB |_|DVBE

Date Quote Received

Date Quote Expires

Seller’s Permit

Warranty Period

Delivery Date

Line

Qty

Description

Unit $

Extension

1.

2.

3.

4.

5.

6.

FOB Destination, Freight Prepaid

Price of freight included in cost of commodity – no additional freight charges added by vendor. State does not own goods during shipment.

FOB Destination, Freight Prepay and Add

Seller prepays freight and adds cost to the invoice. State accepts responsibility for freight upon delivery. Cost of freight must be noted and added in price extension. If freight costs are $50.00 or more, the vendor must attach a copy of the actual freight bill with the invoice to process payment. Freight costs of $500 or more must be approved by Transportation Management call 916-376-1888 for best rates.

FOB Origin, Freight Collect

State accepts ownership responsibility for merchandise at the Seller’s dock and pays freight charges. This is not a suggested method, if used Transportation Management must be called at (916) 376-1888. Cost of freight must be noted and added in price extension.

Subtotal Quote

Total Quote

(Tax is not an evaluation item, add tax to the purchase order)

PREPARED BY:

PRINT NAME:

DATE:

*** See included Attachment(s)