1-26-025 00 43 10 Substitution Reqeust Form.pdf
PDF 217 KB Posted
- Solicitation number
- 26-025
- Issued by
- Winnebago County, Wisconsin
About this file
This is a Substitution Request Form from Walworth County, Wisconsin, for Project #26-025, Kitchen Worktable Replacements for Lakeland Health Care Center and Sheriff's Office. The form serves as the official template and submission mechanism for contractors and bidders to request approval of substitute products or materials that deviate from the specifications outlined in the project documents. The substitution process requires requestors to identify the specification section and paragraph number affected, provide detailed information about the proposed substitute manufacturer and product model, explain the justification for the substitution, and document how the substitution impacts project dimensions, other work sections, and design requirements. Submissions are directed to Carolyn Holt, Senior Buyer, and must be reviewed and approved before incorporation into the project.
The form categorizes substitution requests as either pre-bid (prior approval) or post-bid submissions and requires requestors to provide comparative cost analysis when cost savings are the basis for the substitution. The contractor or bidder submitting the substitution accepts full responsibility for coordination and any additional costs resulting from the proposed change. The reviewing architect or project manager indicates approval status through checkboxes for accepted, not accepted, or no action required, and notes whether submissions are incomplete or submitted too late for consideration. All parties must sign and date the form, including the subcontractor and contractor representatives.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-26-025 - RFB - Final.pdf | ||
| 2-26-025 00 43 10 Substitution Reqeust Form.pdf |
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Text version
Walworth County
SECTION 00 43 10
SUBSTITUTION REQUEST FORM
A/E Project No.:
Date Received:
Specification Section Number and Paragraph:
Drawings and details affected:
Proposed Substitution:
Manufacturer:
Product (model, pattern, etc.):
WHY IS SUBSTITUTION BEING SUBMITTED? (Select one of the following):
Pre-Bid Substitution (Prior Approval) Bid Date:
Specified product is not available. Explain Cost savings to Owner. Attach comparative cost analysis and proposed deduct.
Other. Explain.
EFFECTS OF PROPOSED SUBSTITUTION Answer the following questions and attach explanations.
Does substitution affect dimensions indicated on Drawings?
(NO) (YES, explain)
Does substitution affect Work of other Sections?
(NO) (YES, explain)
Does substitution require modifications to design, changes to Drawings, or revisions to Specifications to be incorporated into the Project?
(NO) (YES, explain)
CONTRACTOR’S/BIDDER’S REPRESENTATION
Undersigned accepts responsibility for coordination of proposed substitution and accepts all additional costs resulting from the incorporation of proposed substitution into the Project.
SUBMITTED BY: For Architect’s Use:
Accepted
Not Accepted
No Action Required Submission: Incomplete Too Late
Reviewed by/Date:
Comments:
Subcontractor’s signature and date:
Contractor’s signature and date:
To: Carolyn Holt, Senior Buyer Project: #26-025 Kitchen Worktable Replacements for Lakeland Health Care Center and Sheriff's Office
| Date Received: |
| Specification Section Number and Paragraph: |
| Drawings and details affected: |
| Proposed Substitution: |
| Manufacturer: |
| Product model pattern etc: |
| SUBMITTED BY 1: |
| SUBMITTED BY 2: |
| Reviewed byDate: |
| Comments: |
| Check Box3: Off |
| Check Box4: Off |
| Check Box2: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box11: Off |
File details come from the government source that posted it. Updated .