15-13 - RFP 3906 Submittal Checklist.pdf

384 KB Posted

Attached to
FIRE HYDRANT PAINTING
Solicitation number
RFP-NH-3906
Issued by
Riverside County, California

About this file

Written by GovTribe AI ·

This document is a submittal checklist and proposal form for RFP #3906 issued by the Eastern Municipal Water District (EMWD) for fire hydrant and blow-off valve painting services in the City of Murrieta, California. The project encompasses the preparation and painting of approximately 1,071 fire hydrants and blow-off valves according to the specifications outlined in the RFP scope of work. Proposers are required to submit a comprehensive bid package that includes pricing information, business qualifications, references, subcontractor details, insurance documentation, and compliance certifications. The proposal form requests a total project price, timeline for completion measured in calendar days, and payment terms including any early payment discounts that the proposer wishes to offer.

The pricing submission must include all labor, equipment, materials, transportation, overhead, travel, profit, insurance, sales taxes, licenses, and incidentals necessary to complete the work. Proposers must provide a minimum of three business references with at least three years of experience, preferably from similar-sized projects. The submittal checklist requires documentation of the proposer's business information, list of subcontractors with California State Contractor's License numbers, qualifications and experience, process and timeframe for completing the work, insurance affidavit certifying compliance with EMWD's insurance requirements, Cal/OSHA compliance history for the past seven to ten years, product safety data sheets, and a contractor mobile source acknowledgement form. Any exceptions, deletions, or modifications to the District's standard contract terms and conditions must be clearly identified at the time of proposal submission, as the District will issue its standard agreement form to the successful bidder.

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Other files

File Type Posted
10-RFP 3906 EXHIBIT B REPORTING WORKSHEET (1).xlsx XLSX spreadsheet
16-01 - RFP 3906 FIRE HYDRANT PAINTING.pdf PDF
2-03 - RFP 3906 Proposers Business References.pdf PDF
3-04 - RFP 3906 List of Subcontractors.pdf PDF
7-07 - RFP 3906 Process to Complete Work.pdf PDF
14-12 - RFP 3906 TIME FRAME.pdf PDF
5-05 - RFP 3906 Additions, Deletions, Exceptions.pdf PDF
13-14 - RFP 3906 Product SDS Sheet.pdf PDF
9-09 - RFP 3906 Contractors CalOSHA.pdf PDF
12-11 - RFP 3906 PRICE FORM.pdf PDF
11-RFP 3906 Proposed FH Painting 11x17 (12-02-2025).pdf PDF
4-06 - RFP 3906 Qualif and Exp.pdf PDF
6-08 - RFP 3906 Insurance Affidavit.pdf PDF
8-10 - RFP 3906 CARB Forms.pdf PDF
1-02 - RFP 3906 Proposers Business Information.pdf PDF
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RFP #XXXX

RFP #3906 PRICE FORM

PROPOSER BUSINESS NAME _

Item

Description

Price

Timeframe

1.

Prep and paint approx. 1071 Fire Hydrants and Blow-off Valves per RFP Scope of Work

2.

Project Total

Total Calendar Days to

Complete

Price(s) shall include all labor, equipment, materials, transportation, overhead, travel, profit, insurance, sales and other taxes, licenses, incidentals, and all other related costs necessary to meet the work requirements.

The District encourages a discount for early payment and will include such offers in the evaluation criteria. If a discount is offered, terms are: % discount if paid in full within days.

The undersigned as Proposer, declares that the only persons or parties interested in this proposal are made without collusion with any person, firm or corporation. Your signature on this document, should you be awarded the contract as defined in this RFP, signifies that you have fully read and understood this proposal and will comply with all specifications, conditions, unit prices, terms, and delivery of the proposal unless otherwise noted in the “exceptions” portion of the proposal.

Name of Offeror (Firm):

Title:

Authorized Signature:

Date:

Printed/Typed Name:

Mailing Address:

Phone:

City, State, Zip:

Fax:

E-Mail

Olivas, James Remove if not needed

PROPOSER’S BUSINESS INFORMATION

Busi

Legal Business ness Information

Street Address Suite #

City State ZIP Code

Contact: Title:

Phone: Email

Length of time in business:

Length of time at current location:

Federal Tax No.

Names and titles of officers of the Business:

Is your firm incorporated? No Yes

Name and remittance address that will appear on invoices:

Is your firm a sole proprietorship doing business under a different name?

No Yes

If yes, please indicate sole proprietorship name and the name you are doing business under:

California State Contractor’s License No.:

Department of Industrial Relations Registration No.:

BUSINESS REFERENCES

Business References f

Proposer Business Name:

or

Date:

Proposer shall provide a minimum of 3 or more Customer References with 3 or more years’ experience with the Proposer. Preferred references should be similar in size, scope, and complexity (to the contract requirements).

Reference 1

Firm:

Address: Contact:

Project

Approx. Cost:

Contact email:

Description:

Project Date: To:

Reference 2

Reference 3

BUSINESS REFERENCES

Business References f

Proposer Business Name:

or

Reference 4

Reference 5

Reference 6

Remove page if you are only requesting 3 references.

LIST OF SUBCONTRACTORS

Subcontractor #1 Information Legal Business

Street Address Suite #

City State ZIP Code

California State Contractor’s License No.:

Department of Industrial Relations Registration No.

Subcontract Description:

Subcontractor #2 Information

Street Address Suite #

City State ZIP Code

California State Contractor’s License No.:

Department of Industrial Relations

Subcontractor #3 Information

Street Address Suite #

City State ZIP Code

California State Contractor’s License No.:

Department of Industrial Relations

ADDITIONS, DELETIONS AND/OR EXCEPTIONS

Please state any and all Additions, Deletions and Exceptions that you are taking to any portion of this proposal. If not addressed below, then Eastern Municipal Water District assumes that the vendor will adhere to all terms and conditions listed.

District will issue an Agreement in its standard form to the successful firm(s) for the services contemplated herein; a copy of which is attached hereto and incorporated herein. Any deletion, exception, or modification taken to District contract terms and conditions will be evaluated, in addition to the specified criteria; and may, itself, result in non-acceptance by the District. Any request for deletion, exception, or modification, if so taken, must be submitted at the time of proposal. Any asserted trade secrets or other proprietary information must be identified on this exhibit with specific page references within the proposal and/or supplemental information.

QUALIFICATIONS AND EXPERIENCE

PROCESS TO COMPLETE WORK

TIMEFRAME TO COMPLETE WORK

INSURANCE AFFIDAVIT

I, (Proposer/Company) have reviewed the Insurance Requirements (Rev. 05/2021) in its entirety and agree to furnish all insurance policies with designated limits, along with full endorsements, and waiver of subrogation, as stated in this Request for Proposal for the full term of the agreement.

I hereby agree to provide copies of insurance certificates, endorsements, and waiver of subrogation within fourteen (14) calendar days of the District’s notification of recommendation of award.

I understand and confirm that our firm is able to provide and maintain the coverage as specified.

Failure to maintain said coverage shall be sufficient cause for contract termination and shall result in termination of the awarded contract.

I understand that by signing this document, I (Proposer/Company) agree to all terms and conditions as stated in the Insurance Requirements (Rev. 05/2021).

☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements (05/2021). Detail all Exceptions in, Additions, Deletions and/or Exceptions Form.

Authorized Representative’s Signature Name Authorized Representative’s Printed Name

Company Name Date

Mailing Address Telephone

City, State, Zip Code Email

CONTRACTOR’S CAL/OSHA COMPLIANCE HISTORY AND SIC CODE

(This document is to be submitted with the proposal package) (rev. 10/08/18)

Contractor’s Standard Industry Code:

Contractor’s Name:

California State Contractor’s License #:

Contact Person:

Phone No:

Please answer the following questions:

1. Has the contractor been cited by Cal/OSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven (7) years?

2. Within the past ten (10) years has the contractor had a serious incident or fatality on a job site?

* If yes to # 1 or #2, please provide information specific to the incident(s) and action(s) taken to ensure that there is not a repeat violation, or incident(s) (attach additional sheets if needed)

Contractor’s Representative signature:

FOR EMWD USE ONLY: Purchasing to forward to Risk Management for review

(Risk Management)

Approved: No Yes

Reviewed by (Risk Management)

(signature required)

Product SDS Sheet

Produc

I don’t think you need this page. They will be providing the SDS sheets. You just need to specify you would like them submitted with the submission.

Contractor Mobile Source Acknowledgement Form

I don’t think you need this page in here. Will you be adding the CARB forms

SUBMITTAL CHECK-OFF LIST

Item Required Submittals Checklist Check

Off

RFP Price Form

Proposer’s Business Information

Proposer’s Business References

List of Subcontractors

Additions, Deletions, and/or Exceptions

Qualifications and Experience

Process to Complete Work

Timeframe to Complete the Work

Insurance Affidavit

CAL/OSHA Compliance History

Product SDS Sheet

Contractor Mobile Source Acknowledgement Form

RFP #3906 PRICE FORM
LIST OF SUBCONTRACTORS
ADDITIONS, DELETIONS AND/OR EXCEPTIONS
District will issue an Agreement in its standard form to the successful firm(s) for the services contemplated herein; a copy of which is attached hereto and incorporated herein. Any deletion, exception, or modification taken to District contract terms...
☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements (05/2021). Detail all Exceptions in, Additions, Deletions and/or Exceptions Form.
(This document is to be submitted with the proposal package) (rev. 10/08/18)

SUBMITTAL CHECK-OFF LIST

PROPOSER BUSINESS NAME:
1:
undefined:
Timeframe:
Prep and paint approx 1071 Fire Hydrants and Blowoff Valves per RFP Scope of Work2:
undefined_2:
Timeframe_2:
2Row1:
Project Total:
undefined_3:
evaluation criteria If a discount is offered terms are:
days:
Offeror Firm:
Title:
Authorized:
Date:
PrintedTyped:
Address:
undefined_4:
State Zip:
Address_2:
EMail:
Name:
Date_2:
Address_3:
City:
State:
ZIP Code:
Contact:
Phone:
in business:
current location:
undefined_5:
undefined_6:
Names and titles of officers of the Business 1:
Names and titles of officers of the Business 2:
Names and titles of officers of the Business 3:
Is your firm incorporated: Off
Is your firm a sole proprietorship doing business under a different name: Off
Name_2:
Date_3:
Firm:
Phone_2:
Address_4:
Contact_2:
Title_2:
Description:
Date_4:
Firm_2:
Phone_3:
Address_5:
Contact_3:
Title_3:
Description_2:
Date_5:
Firm_3:
Phone_4:
Address_6:
Contact_4:
Title_4:
Description_3:
Date_6:
BUSINESS REFERENCES:
Name_3:
Date_7:
Firm_4:
Phone_5:
Address_7:
Contact_5:
Title_5:
Description_4:
Date_8:
Firm_5:
Phone_6:
Address_8:
Contact_6:
Title_6:
Description_5:
Date_9:
Firm_6:
Phone_7:
Address_9:
Contact_7:
Title_7:
Description_6:
Date_10:
Name_4:
Date_11:
Address_10:
Contractors License No:
Registration No:
Subcontract Description:
Name_5:
Date_12:
Address_11:
Contractors License No_2:
Registration No_2:
Subcontract Description_2:
Name_6:
Date_13:
Address_12:
Contractors License No_3:
Registration No_3:
Subcontract Description_3:
supplemental information 1:
supplemental information 2:
supplemental information 3:
supplemental information 4:
supplemental information 5:
supplemental information 6:
supplemental information 7:
supplemental information 8:
supplemental information 9:
supplemental information 10:
supplemental information 11:
supplemental information 12:
supplemental information 13:
1_2:
2:
3:
4:
5:
6:
7:
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9:
10:
11:
12:
13:
14:
15:
16:
1_3:
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1_4:
2_3:
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5_3:
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1_7:
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Requirements Rev 052021 in its entirety and agree to furnish all insurance policies with:
Check here if you DO NOT accept terms and conditions as stated in the Insurance: Off
Company Name:
Mailing Address:
City State Zip Code:
Authorized Representatives Printed Name:
Date_14:
Telephone:
Email:
Date_15:
Contractors Standard Industry Code:
Contractors Name:
California State Contractors License:
Address_13:
Contact Person:
Phone No:
or environmental issues within the past seven 7 years: Off
Within the past ten 10 years has the contractor had a serious incident or fatality on a job site: Off
Please answer the following questions 1 Has the contractor been cited by CalOSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven 7 years No Yes 2 Within the past ten 10 years has the contractor had a serious incident or fatality on a job site No Yes If yes to 1 or 2 please provide information specific to the incidents and actions taken to ensure that there is not a repeat violation or incidents attach additional sheets if neededRow1:
Please answer the following questions 1 Has the contractor been cited by CalOSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven 7 years No Yes 2 Within the past ten 10 years has the contractor had a serious incident or fatality on a job site No Yes If yes to 1 or 2 please provide information specific to the incidents and actions taken to ensure that there is not a repeat violation or incidents attach additional sheets if neededRow2:
Please answer the following questions 1 Has the contractor been cited by CalOSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven 7 years No Yes 2 Within the past ten 10 years has the contractor had a serious incident or fatality on a job site No Yes If yes to 1 or 2 please provide information specific to the incidents and actions taken to ensure that there is not a repeat violation or incidents attach additional sheets if neededRow3:
Please answer the following questions 1 Has the contractor been cited by CalOSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven 7 years No Yes 2 Within the past ten 10 years has the contractor had a serious incident or fatality on a job site No Yes If yes to 1 or 2 please provide information specific to the incidents and actions taken to ensure that there is not a repeat violation or incidents attach additional sheets if neededRow4:
Please answer the following questions 1 Has the contractor been cited by CalOSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven 7 years No Yes 2 Within the past ten 10 years has the contractor had a serious incident or fatality on a job site No Yes If yes to 1 or 2 please provide information specific to the incidents and actions taken to ensure that there is not a repeat violation or incidents attach additional sheets if neededRow5:
Date_16:
FOR EMWD USE ONLY:
Date Risk Management:
Approved No:
Yes_5:
Reviewed by Risk Management:
signature required:
Check OffRFP Price Form:
Check OffProposers Business Information:
Check OffProposers Business References:
Check OffList of Subcontractors:
Check OffAdditions Deletions andor Exceptions:
Check OffQualifications and Experience:
Check OffProcess to Complete Work:
Check OffTimeframe to Complete the Work:
Check OffInsurance Affidavit:
Check OffCALOSHA Compliance History:
Check OffProduct SDS Sheet:
Check OffContractor Mobile Source Acknowledgement Form:

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