157909 Required Forms.pdf

791 KB Posted

Attached to
IFB 157280 Flagging Services with Pickup Truck
Solicitation number
6699
Issued by
Accomack County, Albemarle County, Arlington County, Chesterfield County, Halifax County, Richmond County, Rockingham County, Virginia

About this file

Written by GovTribe AI ·

This document is an Invitation for Bid (IFB) issued by the Virginia Department of Transportation (VDOT) for equipment and services related to the state's transportation infrastructure maintenance and operations. The IFB requires bidders to provide information on owned, rented, leased, or purchased equipment that will be used to perform the services. Bidders must complete an equipment inventory certification form listing all relevant equipment details. For any rented, leased, or purchased equipment, the bidder must provide additional documentation prior to the notice of intent to award. The contract term is unspecified, but the IFB indicates the equipment must be available by the date of award.

The IFB also requires bidders to complete a Small Business Subcontracting Plan, with the goal of awarding over 42% of the contract value to certified small businesses, including women-owned, minority-owned, and service-disabled veteran-owned firms. Bidders must provide details on their plans to utilize DSBSD-certified small businesses as subcontractors. The IFB provides instructions and forms for bidders to submit their qualifications, references, and other required information.

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Notice of Award —
Notice of Intent to Award —
157909 Specifications.pdf PDF
NOA and Bid Tab —

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Administrative Services Division/Procurement

ATTACHMENT

IFB #:

VENDOR QUALIFICATION / EQUIPMENT

INVENTORY CERTIFICATION

All bidders responding to this IFB are required to complete equipment information for each piece of equipment listed in question #4.

Failure to complete this attachment may render the bid non-responsive.

1. Name of Business:

2. Name of Owner or Chief Executive Officer: Telephone Number:

3. How many years has the firm been in the business of performing the services called for in this IFB?

4. All equipment that will require inspection by VDOT prior to Notice of Award is listed below.

• In Column 1 place an “O” beside each piece of owned equipment. Place N/A in any block (YEAR/MAKE/MODEL/CAPACITY/ID#/VIN) that does not apply for owned equipment

• In Column 1 place an “R” beside each piece of equipment that will be rented/leased or sub-contracted

• In Column 1 place a “P” beside each piece of equipment that is to be purchased.

• For rented, subcontracted or purchased equipment no detail (Year/Make/Model/Capacity/ID#VIN) is required at time of bid submission.

• See #5 for rented/leased, sub-contracted or purchased equipment requirements.

“O” “R” “P” DESCRIPTION YEAR MAKE MODEL CAPACITY ID #/VIN

A

“O” “R” “P” DESCRIPTION YEAR MAKE MODEL CAPACITY ID #/VIN

5. Rented, leased equipment: Prior to Notice of Intent to Award VDOT shall require the bidder to provide a letter from the applicable entity on company letterhead stating the type of equipment with detailed equipment description and availability for the duration of the contract period, for any equipment intended for use to perform services of this IFB. This letter must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive.

Sub-Contracted equipment: Prior to Notice of Intent to Award VDOT shall require the bidder to complete the sub-contracting form identifying the company they intend to use for sub-contracting and listing of the equipment. This form must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive.

Future equipment purchase: Prior to Notice of Intent to Award, VDOT shall require the bidder to provide proof of purchase with detailed equipment description and confirmed delivery date for any equipment intended for use to perform services of this IFB.

This proof of purchase must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive. All purchased equipment must be available by date of award.

6. Is any of the equipment listed above currently committed on any other contract (VDOT / non VDOT) contracts? Yes No

If yes, identify which equipment (year, make, model, ID/VIN), where the equipment is committed, contract number(s), name the party to the contract and location.

ATTACHMENT _____

State Corporation Commission Form

Failure to complete and return this attachment may result in your bid being deemed NON-RESPONSIVE.

Solicitation #:

Virginia State Corporation Commission (SCC) registration information.

The bidder:

is a corporation or other business entity with the following SCC identification number:

-OR-

is not a corporation, limited liability company, limited partnership, registered limited liability partnership, or business trust -OR-is an out-of-state business entity that does not regularly and continuously maintain as part of its ordinary and customary business any employees, agents, offices, facilities, or inventories in Virginia (not counting any employees or agents in Virginia who merely solicit orders that require acceptance outside Virginia before they become contracts, and not counting any incidental presence of the bidder in Virginia that is needed in order to assemble, maintain, and repair goods in accordance with the contracts by which such goods were sold and shipped into Virginia from bidder’s out-of-state location) -OR-is an out-of-state business entity that is including with this bid an opinion of legal counsel which accurately and completely discloses the undersigned bidder’s current contacts with Virginia and describes why those contacts do not constitute the transaction of business in Virginia within the meaning of § 13.1-757 or other similar provisions in Titles

13.1 or 50 of the Code of Virginia.

**NOTE** >> Check the following box if you have not completed any of the foregoing options but currently have pending before the SCC an application for authority to transact business in the Commonwealth of Virginia and wish to be considered for a waiver to allow you to submit the SCC identification number after the due date for bids (the Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver):

B

ATTACHMENT ____

NORMAL AND EMERGENCY CONTACTS

Solicitation # ___________

Send Contracts To:

Bidder's Name/Title

Primary Phone Number

Bidder's Mailing Address E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

C

ATTACHMENT __D____

Solicitation #:

SUBCONTRACTOR APPROVAL REQUEST

No portion of the work (including equipment) shall be subcontracted to another firm or individual without prior written consent of Virginia Department of Transportation (herein referred to as VDOT). In the event that the contractor desires to subcontract some part of the work specified herein, the contractor shall furnish VDOT with the names, qualifications, and experience of their proposed subcontractors for agency approval. The primary contractor shall, however, remain fully liable and responsible for the work performed by its subcontractor(s) and shall assure compliance with all requirements of the contract.

List proposed subcontractor(s), including name, address, contact person, and type of work to be performed under this contract below.

FIRM INDIVIDUAL’S

NAME & ADDRESS

CONTACT PERSON AND

PHONE NUMBER

TYPE OF WORK TO BE

PERFORMED

TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE

QUALIFICATIONS / EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR

Please indicate which above proposed subcontractors are certified (with DSBSD) as Small, Women Owned or Minority Businesses.

Certification Number(s):

FOR VDOT USE ONLY:

The proposed subcontractor(s) listed above is/are approved and accepted under the terms and conditions of the contract requirements herein.

Signature of Authorized VDOT Representative Date Telephone Number

Solicitation # ____________

REFERENCES

Bidders should provide a list of at least 3 references where similar goods and/or services have been provided. Each reference shall include the name of the organization, the complete mailing address, the name of the contact person, the email, and the telephone/fax number.

FIRM’S NAME AND ADDRESS CONTACT PERSON EMAIL ADDRESS TELEPHONE / FAX #

F

SBSP-IFB PIM-40

Small Business Subcontracting Plan

IFB # ____________

It is the goal of the Commonwealth that over 42% of its purchases be made from small businesses. All potential bidders are required to include this document with their bid response in order to be considered responsive.

Small Business: "Small business (including micro)” means a business which holds a certification as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD) on the due date for bids.

This shall also include DSBSD-certified women- owned and minority-owned businesses and businesses with DSBSD service disabled veteran owned status when they also hold a DSBSD certification as a small business on the bid due date. Currently, DSBSD offers small business certification and micro business designation to firms that qualify.

Certification applications are available through DSBSD online at www.SBSD.virginia.gov (Customer Service).

Bidder Name:

Preparer Name: Date:

Who will be doing the work: □ I plan to use subcontractors □ I plan to complete all work

Instructions A. If you are certified by the DSBSD as a micro/small business, complete only Section A of this form.

B. If you are not a DSBSD-certified small business, complete Section B of this form. For the bid to be considered and the bidder to be declared responsive, the bidder shall identify the portions of the contract that will be subcontracted to DSBSD-certified small business for the initial contract period in relation to the bidder’s total price for the initial contract period in Section B.

Section A If your firm is certified by the DSBSD provide your certification number and the date of certification.

Certification number: Certification Date:

Section B If the “I plan to use subcontractors box is checked,” populate the requested information below, per subcontractor to show your firm's plans for utilization of DSBSD-certified small businesses in the performance of this contract for the initial contract period in relation to the bidder’s total price for the initial contract period. Certified small businesses include but are not limited to DSBSD-certified women-owned and minority-owned businesses and businesses with DSBSD service disabled veteran-owned status that have also received the DSBSD small business certification. Include plans to utilize small businesses as part of joint ventures, partnerships, subcontractors, suppliers, etc. It is important to note that these proposed participation will be incorporated into the subsequent contract and will be a requirement of the contract. Failure to obtain the proposed participation percentages may result in breach of the contract.

I

SBSP-IFB PIM-40

B. Plans for Utilization of DSBSD-Certified Small Businesses for this Procurement

Subcontract #1

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #2

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #3

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #4

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #5

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

ATTACHMENT
IFB #:
In Column 1 place an “R” beside each piece of equipment that will be rented/leased or sub-contracted
ATTACHMENT State Corporation Commission Form.pdf
Failure to complete and return this attachment may result in your bid being deemed NON-RESPONSIVE.
-OR-
ATTACHMENT Normal and Emergency Contacts.pdf
NORMAL AND EMERGENCY CONTACTS
Solicitation # ___________
ATTACHMENT Subcontracting Approval Request.pdf
Solicitation #:
FIRM INDIVIDUAL’S
TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE
FOR VDOT USE ONLY:
ATTACHMENT References.pdf
ATTACHMENT _____
1 Name of Business:
Name of Owner or ChiefExecutive Officer:
How many years has the firm been in the business of performing the services called for in this IFB:
O R PRow1:
DESCRIPTIONRow1: Truck Mounted Crash Cushion
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party to the contract and location 1:
party to the contract and location 2:
party to the contract and location 3:
party to the contract and location 4:
ATTACHMENT:
The bidder:
is a corporation or other business entity with the following SCC identification number:
OR: Off
is not a corporation limited liability company limited partnership registered limited liability partnership or: Off
is an outofstate business entity that does not regularly and continuously maintain as part of its ordinary and: Off
is an outofstate business entity that is including with this bid an opinion of legal counsel which accurately and: Off
undefined: Off
Solicitation: 157909
Send Contracts To Bidders NameTitle:
Primary Phone Number:
Bidders Mailing Address:
Email Address:
Contact Persons Name:
Cellular Telephone Number:
Telephone Number Normal Work Hours:
Telephone Number After Work Hours:
Fax Number:
Email Address_2:
Contact Persons Name_2:
Cellular Telephone Number_2:
Telephone Number Normal Work Hours_2:
Telephone Number After Work Hours_2:
Fax Number_2:
Email Address_3:
Contact Persons Name_3:
Cellular Telephone Number_3:
Telephone Number Normal Work Hours_3:
Telephone Number After Work Hours_3:
Fax Number_3:
Email Address_4:
NAME ADDRESS 1:
NAME ADDRESS 2:
NAME ADDRESS 3:
NAME ADDRESS 4:
PHONE NUMBER 1:
PHONE NUMBER 2:
PHONE NUMBER 3:
PHONE NUMBER 4:
PERFORMED 1:
PERFORMED 2:
PERFORMED 3:
PERFORMED 4:
TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 1:
TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 2:
QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 1:
QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 2:
Certification Numbers 1:
Certification Numbers 2:
contract requirements herein:
The proposed subcontractors listed above isare approved and accepted under the terms and conditions of the:
Telephone Number:
FIRMS NAME AND ADDRESSRow1:
CONTACT PERSONRow1:
EMAIL ADDRESSRow1:
TELEPHONE FAX Row1:
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IFB: 157909
Bidder Name:
Preparer Name:
Date:
I plan to use subcontractors: Off
I plan to complete all work: Off
Certification number:
Certification Date:
Company Name:
SBSD Cert:
Contact Name:
SBSD Certification:
Contact Phone:
Contact Email:
Value Initial Term:
Contact Address:
Description of Work:
Company Name_2:
SBSD Cert_2:
Contact Name_2:
SBSD Certification_2:
Contact Phone_2:
Contact Email_2:
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SBSD Cert_3:
Contact Name_3:
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Value Initial Term_3:
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Company Name_4:
SBSD Cert_4:
Contact Name_4:
SBSD Certification_4:
Contact Phone_4:
Contact Email_4:
Value Initial Term_4:
Contact Address_4:
Description of Work_4:
Company Name_5:
SBSD Cert_5:
Contact Name_5:
SBSD Certification_5:
Contact Phone_5:
Contact Email_5:
Value Initial Term_5:
Contact Address_5:
Description of Work_5:

File details come from the government source that posted it. Updated .