158224 IFB BWMT Ventilation Saccardo Nozzles_Required Forms.pdf
PDF 718 KB Posted
- Attached to
- Emergency Ventilation BWMT
- Solicitation number
- 56792
- Issued by
- Bland County, Virginia
About this file
This document is a set of supplemental instructions to bidders for Invitation for Bid (IFB) 158224 for the Big Walker Mountain Tunnel Ventilation Saccardo Nozzles project in Virginia. The project is being conducted by the Virginia Department of Transportation (VDOT). To access the project plans in VDOT's ProjectWise system, bidders must complete and submit a CII/SSI Non-Disclosure Agreement, ITD-36E, and LD-899 forms. Upon confirmation of account creation and project access, bidders will receive an email with a link to the project and any additional instructions. The project has a time for Substantial Completion of 305 consecutive calendar days and Final Completion within 30 days after Substantial Completion.
The bid form shows the Base Bid is for the lump sum price to construct the Big Walker Mountain Tunnel Ventilation Saccardo Nozzles project. Bidders must provide the Total Base Bid Amount and acknowledge receipt of any addenda. The Commonwealth of Virginia requires a 5% bid bond. The contract will be awarded based on the Total Base Bid Amount. The project has a small business participation requirement of 50%, which bidders must provide their proposed percentage.
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SUPPLEMENTAL INSTRUCTIONS TO BIDDERS
The plans will be made available in VDOT’s ProjectWise file management system upon successful completion and submission of the CII/SSI Multi-Purpose Non- Disclosure Agreement (NDA), ITD-36E, and LD-899 (completely filled out and signed) forms to VDOT Procurement Officer. Once VDOT Procurement Officer receives conformation of your account creation and project access from Design Technologies, you will receive an email from VDOT Procurement Officer containing a hyperlink to your project and any additional instructions for your individual access.
If you have any questions about your ProjectWise account or need assistance using ProjectWise, contact Design Technologies directly at designtechnologies@vdot.virginia.gov or at (804) 786-1280. Additional guidance and system access information is available at https://www.vdot.virginia.gov/doing-business/tools/projectwise.
VDOT Procurement Officer: George Jellerson george.jellerson@vdot.virginia.gov mailto:designtechnologies@vdot.virginia.gov https://www.vdot.virginia.gov/doing-business/tools/projectwise mailto:george.jellerson@vdot.virginia.gov
COMMONWEALTH OF VIRGINIA
STANDARD BID BOND
KNOW ALL MEN BY THESE PRESENTS: That , the
Contractor (“Principal”) whose principal place of business is located at and
(“Surety”) whose address for delivery of ‘Notices’ is located at are held and firmly bound unto the Commonwealth of Virginia, Virginia Department of
Transportation, the Owner (“Obligee”) in the amount of five percent (5%) of the Amount (Total
Base Bid plus all Additive Bid Items) Bid by Principal, for the payment whereof, Principal and
Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has submitted a bid for IFB 158224, Big Walker Mountain Tunnel Ventilation Saccardo Nozzles.
NOW, THEREFORE, the conditions of this obligation are as follows. This Bid Bond shall guarantee that the Principal will not withdraw his bid during the period of sixty (60) days following the opening of bids; that if his bid is accepted, Principal will enter into a formal contract with the Owner in accordance with the Contract Between Owner and Contractor, Form CO-9, included as a part of the Invitation for Bids (IFB Documents); that Principal will submit a properly executed and authorized Standard Performance Bond and Standard Labor and Material Payment Bond on the forms included in the IFB documents; and that in the event of the withdrawal of said bid within said period, or failure to enter into said contract and give said bonds within ten (10) days after Principal has received notice of acceptance of his bid, Principal and Surety shall be jointly and severally liable to the Owner for the difference between the amount specified in said bid and such larger amount for which the Owner may contract with another party to perform the work covered by said bid, up to the amount of the bid guarantee.
This amount represents the damage to the Owner of account of the default of the bidder in any particular thereof.
The Surety represents to the Principal and to the Obligee that it is legally authorized to do business in the Commonwealth of Virginia.
DGS-30-090GS-30
(Rev. 07/21) Page 1 of 2
CO-10.2
Signed and sealed this day of
Contractor / Principal (SEAL)
By:
Witness Typed Name:
Title:
Surety (SEAL)
By:
Attorney-in-Fact
Typed Name:
AFFIDAVIT AND ACKNOWLEDGEMENT OF ATTORNEY-IN-FACT
COMMONWEALTH / STATE OF )
CITY/COUNTY/TOWN of
I, the undersigned notary public, do certify that , whose name is signed to the foregoing bid bond in the amount of five percent (5%) of the Total Bid Amount and which names the Commonwealth of Virginia, Virginia Department of Transportation, as Obligee, personally appeared before me today in the above jurisdiction and made oath that he/she is the attorney-in- fact of
, a corporation which is the Surety in the foregoing bond, that he/she is duly authorized to execute on the above Surety’s behalf the foregoing bond pursuant to the Power of Attorney noted above and attached hereto, and on behalf of the surety, he/she acknowledged the foregoing bond before me as the above Surety’s act and deed.
She/he has further certified that her/his Power of Attorney has not been revoked.
[Complete if Power is recorded: Clerk’s Office: ;
Deed Book/Page No. or Instrument No.: .]
Given under my hand this day of .
Notary Public (SEAL) My name (printed) is:
My registration number is:
My commission expires: _______________
DGS-30-090GS-30
(Rev. 07/21) Page 2 of 2
CO-10.2
PREBID QUESTION FORM
(Use separate Form for each question submitted.)
Date:
Project Title: IFB 158224 Big Walker Mountain Tunnel Ventilation Saccardo Nozzles
Project Code No.: 0077-010-849
The following question concerns Drawing Sheet (number) :
The following question concerns Specifications Section (number) , page _________, paragraph _______:
All responses to questions will be made by Addendum.
Question submitted by:
Name Organization
Bidders shall submit form to: Virginia Department of Transportation
Name George Jellerson, Senior Procurement Officer
Email address: george.jellerson@vdot.virginia.gov
DGS-30-272
(Rev. 04/15)
DGS-30-220
(Rev. 07/22)
BID FORM
DATE: ________________
PROJECT: IFB 158224 Big Walker Mountain Tunnel Ventilation Saccardo Nozzles Bland County, Virginia
Project Code: 0077-010-849
To: Commonwealth of Virginia Virginia Department of Transportation 1201 E. Broad St.
Richmond, VA 23219
In compliance with and subject to your Invitation for Bids and the documents therein specified, all of which are incorporated herein by reference, the undersigned bidder proposes to furnish all labor, equipment, and materials and perform all work necessary for construction of this project, in accordance with the Plans and Specifications dated August 4, 2023, and the Addenda noted below, as prepared by Jacobs Engineering for the consideration of the following amount:
BASE BID:
Lump sum price for the construction of Big Walker Mountain Tunnel Ventilation Saccardo Nozzles complete and in accordance with the Plans and Specifications:
TOTAL BASE BID AMOUNT IS:
_______________________________________________________ DOLLARS ($ )
Contract award will be based on the TOTAL BASE BID AMOUNT shown above (including any properly submitted bid modifications).
The bidder has relied upon the following public historical climatological records:
National Weather Service (National Oceanic and Atmospheric Administration) for Marion / Wytheville, VA (KMKJ).
Code of Virginia, § 2.2-4376.2 shall be applicable to the Work of the Contract.
The undersigned understands that time is of the essence and agrees that the time for Substantial Completion of the entire project shall be three hundred and five (305) consecutive calendar days from the date of commencement of the Work as specified in the Notice to Proceed, and Final Completion shall be achieved within 30 consecutive calendar days after the date of Substantial Completion as determined by the A/E.
Acknowledgment is made of receipt of the following Addenda:
Number 1 Date: Signature:
Number 2 Date: Signature:
Number 3 Date: Signature:
Number 4 Date: Signature:
Number 5 Date: Signature:
Number 6 Date: Signature:
Number 7 Date: Signature:
Number 8 Date: Signature:
Number 9 Date: Signature:
If notice of acceptance of this bid is given to the undersigned within 30 days after the date of opening of bids, or any time thereafter before this bid is withdrawn, the undersigned will execute and deliver a contract in the prescribed form (Commonwealth of Virginia Contract Between Owner and Contractor, Form CO-9) within 10 days after the contract has been presented to him for signature.
The required payment and performance bonds, on the forms prescribed, shall be delivered to the Owner along with the signed Contract.
Immigration Reform and Control Act of 1986: The undersigned certifies that it does not and shall not during the performance of the Contract for this project violate the provisions of the Federal Immigration Reform and Control Act of 1986, which prohibits employment of illegal aliens, or knowingly employ an unauthorized alien as defined in the Federal Immigration Reform and Control Act of 1986.
DISQUALIFICATION OF CONTRACTORS: By signing this bid or proposal, the undersigned certifies that this Bidder or any officer, director, partner or owner is not currently barred from bidding on contracts by any Agency of the Commonwealth of Virginia, or any public body or agency of another state, or any agency of the federal government, nor is this Bidder a subsidiary or affiliate of any firm/corporation that is currently barred from bidding on contracts by any of the same. We have attached an explanation of any previous disbarment(s) and copies of notice(s) of reinstatement(s).
Either the undersigned or one of the following individuals, if any, is authorized to modify this bid prior to the deadline for receipt of bids by writing the modification and signing his name on the face of the bid, on the envelope in which it is enclosed, on a separate document, or on a document which is telefaxed to the Owner:
I certify that the firm name given below is the true and complete name of the bidder and that the bidder is legally qualified and licensed by the Virginia Department of Professional and Occupational Regulation, Board for Contractors, to perform all Work included in the scope of the Contract.
Virginia License No.: ______________ Bidder: ______________________________ (Name of Firm)
Contractor Class: ________________ By:___________________________________ (Signature)
Specialty: _______________________ Valid until: ______________________
FEIN/SSN: _____________________ Title: _______________________________
If General Partnership (List Partners' Names)
FAX # _______________________________
Business Address:
Telephone # ________________________
If Corporation, affix Corporate Seal & list State of Incorporation
State: _____________________________
(Affix Seal)
Virginia State Corporation Commission ID No.: _______________; or
If Contractor is a foreign business entity not required to be authorized to transact business in the Commonwealth under Titles 13.1 or 50 of the Code of Virginia, or as otherwise required by law, please provide an explanation as to why such entity is not required to be so authorized: ____________________
Agency Small Business Participation Requirement: 50%
Contractor’s Proposed Small Business Participation: ____% [Contractor insert percentage] (required)
DGS-30-360
(Rev 07/22)
PARTICIPATION IN STATE PROCUREMENT TRANSACTIONS
BY
MICRO BUSINESSES, SMALL BUSINESSES,
AND
BUSINESSES OWNED BY WOMEN, MINORITIES AND SERVICE-DISABLED VETERANS
The Proposer is required to provide information concerning utilization of micro businesses, small businesses, women-owned businesses, minority-owned businesses and service-disabled veteran-owned businesses proposed for this project as well as on past projects. Failure to complete and return this form with the response to the RFP will result in the proposing firm being considered “non-responsive”.
PART I – DEFINITIONS
The definitions below are applicable to vendors doing business with the Commonwealth of Virginia. Federal definitions shall govern with respect to meeting federally funded highway construction and other federally financed programs.
DSBSD: Virginia Department of Small Business and Supplier Diversity Historically Black Colleges and Universities: Any college or university that was established prior to 1964; whose principal mission was, and is, the education of black Americans; and that is accredited by a nationally recognized accrediting agency or association determined by the Secretary of Education.
Micro Business: A small business certified as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD). For purposes of DSBSD micro certification, the business must have no more than 25 employees and has no more than $3 million in average annual revenue over the three-year period prior to certification.
Minority Individual: An individual who is a citizen of the United States or a legal resident alien and who satisfies one or more of the following definitions:
1. African American: A person having origins in any of the original peoples of Africa and who is regarded as such by the community of which this person claims to be a part.
2. Asian American: A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands, including but not limited to Japan, China, Vietnam, Samoa, Laos, Cambodia, Taiwan, Northern Mariana Islands, the Philippines, a U.S. territory of the Pacific, India, Pakistan, Bangladesh, or Sri Lanka, and who is regarded as such by the community of which this person claims to be a part.
3. Hispanic American: A person having origins in any of the Spanish-speaking peoples of Mexico, South or Central America, or the Caribbean Islands or other Spanish or Portuguese cultures and who is regarded as such by the community of which this person claims to be a part.
4. Native American: A person having origins in any of the original peoples of North America and who is regarded as such by the community of which this person claims to be a part or who is recognized by a tribal organization.
Minority-Owned Business: A business certified as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD). The Code of Virginia defines this to include businesses that are at least 51 percent owned by one or more minority individuals who are U.S. citizens or legal resident aliens, or in the case of a corporation, partnership, or limited liability company or other entity, at least 51 percent of the equity ownership interest in the corporation, partnership, or limited liability company or other entity is owned by one or more minority individuals who are U.S. citizens or legal resident aliens, and both the management and daily business operations are controlled by one or more minority individuals, or any historically black college or university, regardless of the percentage ownership by minority individuals or, in the case of a corporation, partnership, or limited liability company or other entity, the equity ownership interest in the corporation, partnership, or limited
Service Disabled Veteran: A veteran who (i) served on active duty in the United States military ground, naval, or air service,
(ii) was discharged or released under conditions other than dishonorable, and (iii) has a service-connected disability rating fixed by the United States Department of Veterans Affairs.
Service Disabled Veteran-Owned Business: A business certified as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD). The Code of Virginia defines this to include businesses that are at least 51 percent owned by one or more service disabled veterans or, in the case of a corporation, partnership, or limited liability company or other entity, at least 51 percent of the equity ownership interest in the corporation, partnership, or limited liability company or other entity is owned by one or more individuals who are service disabled veterans and both the management and daily business operations are controlled by one or more individuals who are service disabled veterans.
Small Business: A business certified by the Virginia Department of Small Business and Supplier Diversity (DSBSD) as compliant with Code of Virginia, §§ 2.2-1604 and 2.2-4310. The Code of Virginia defines a “small business” as one that is at least 51% independently owned and controlled by one or more individuals, or in the case of a cooperative association organized pursuant to Chapter 3 (§ 13.1-301 et seq.) of Title
13.1 as a nonstock corporation, controlled by one or more members, who are U.S. citizens or legal resident aliens, and together with affiliates, has 250 or fewer employees or average gross receipts of $10 million or less averaged over the previous three years. One or more of the individual owners or members shall control both the management and daily business operations of
Women-Owned Business: A business certified as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD). The Code of Virginia defines this to include businesses which are at least 51 percent owned by one or more women who are U.S. citizens or legal resident aliens, or in the case of a corporation, partnership, or limited liability company or other entity, at least 51 percent of the equity ownership interest is owned by one or more women who are U.S. citizens or legal resident aliens, and both the management and daily business operations are controlled by one or more women.
OFFEROR / PROPOSER:
Firm Name:
Contact Person:
Phone Number:
DPOR Registration # :
PROPOSAL FOR:
Agency:
Project Title:
Project Code No.:
VA Department of PARTICIPATION STATUS: Small Business and
Supplier Diversity As defined by Part I: (DSBSD) Certificate #
Is the Proposer a Micro Business?
Is the Proposer a Small Business?
Is the Proposer a Woman-Owned Business?
Is the Proposer a Minority-Owned Business?
Is the Proposer a Service-Disabled Veteran-Owned Small Business?
REMARKS / COMMENTS:
PART II
DATA ON FIRM SUBMITTING PROPOSAL
DGS-30-360 PART III
(Complete additional pages if needed.)
OFFEROR / PROPOSER:
Firm Name:
Contact Person:
Phone Number:
PROPOSAL FOR PROJECT:
Agency:
Project:
Project Code No.:
List Offeror's plans to involve micro businesses, small businesses, businesses owned by women, businesses owned by minorities, and businesses owned by service-disabled veterans in the performance of this contract either as part of a joint venture, as a partnership, as subcontractors, as consultants, or as suppliers. Offerors are encouraged to provide additional information and expand upon the following format.
DPOR Registration # (if applicable)
Estimated Contract
Amount ...
LISTING OF SMALL/DIVERSE BUSINESSES PROPOSED FOR THIS PROJECT
Date Form Completed:
DSBSD Certificate
… or % of Total
Contract Firm Name Firm Address Services or Materials ProvidedContact Person/
Phone Number
Sm al l B us in es s
Firm Type
Se rv ic e
D is ab le d Ve te ra n- O w ne d B us in es s
M in or ity
-O w ne d
B us in es s
M ic ro B us in es s
W om en -O w ne d B us in es s
(Complete additional pages if needed)
OFFEROR / PROPOSER:
Firm Name:
Contact Person:
Phone Number:
SMALL BUSINESS UTILIZATION REPORT FOR PAST PROJECT:
Agency: % Project: Actual small business participation: %
Project Code No.: (Include ONLY small and micro business participation)
List micro businesses, small businesses, businesses owned by women, businesses owned by minorities, and businesses owned by service-disabled veterans with which the offeror has contracted or done business with on the project noted above. Also list the dollar amount spent with each of these businesses. Offerors are encouraged to provide additional information and expand upon the following format.
Firm Name Firm Address DSBSD Certificate # Services or Materials ProvidedDPOR Registration
# (if applicable)
PART IV
LISTING OF PAST UTILIZATION OF SMALL/DIVERSE BUSINESSES BY PROPOSER
Contact Person/ Phone Number
Is this the final report?
Proposed small business participation:
Date Form Completed:
M ic ro B us in es s
M in or ity
-O w ne d
B us in es s
% Of Total ContractContract Amount
W om en -O w ne d B us in es s
Se rv ic e
D is ab le d Ve te ra n- O w ne d B us in es s
Sm al l B us in es s
Firm Type
Critical Infrastructure Information/Sensitive Security Information (CII/SSI) Multi-Purpose Non-Disclosure Agreement
Retain a copy of both the front and back sides of this form for future reference
VDOT requires CII/SSI be protected and not disclosed to unauthorized persons.
PART A: To Be Completed By Individual VDOT or Company Employee I agree with the following as a condition of being granted access to CII/SSI:
CII/SSI, which is valuable and sensitive, is protected by law and by strict VDOT policies. The intent of these laws and policies is to assure that CII/SSI will remain confidential - that is, it will be used only as necessary to accomplish VDOT’s mission. Disclosure of CII/SSI in any manner that permits interception by unauthorized persons could compromise safety and security and is prohibited. CII/SSI may be released only to persons with a need-to-know.
I might have access to this information in various formats including but not limited to documents and drawings, physical structures, and computer based systems. I have no right or ownership interest in any VDOT CII/SSI.
VDOT may at any time revoke my authorization allowing access to CII/SSI.
Willful violation of this agreement may subject me to discipline which might include, but is not limited to, removal from current VDOT projects;
exclusion from further VDOT related work; and legal liability. My obligations with respect to the confidentiality and security of all CII/SSI disclosed to me shall survive the termination of any agreement or relationship with VDOT. My execution of this agreement shall not nullify or affect in any manner any other agreement, non-disclosure or otherwise, which I have executed or may execute with VDOT or the Commonwealth of Virginia.
I am obligated to protect this information from unauthorized disclosure in accordance with the terms of this agreement. I will only use CII/SSI that I obtain to perform my legitimate VDOT related duties. I will conduct myself in a strict conformance to applicable laws and VDOT policies governing CII/SSI. I will safeguard the confidentiality of all CII/SSI at all times. I will be responsible for my misuse or my wrongful disclosure of CII/SSI.
Each provision of this agreement is severable. If any administrative or judicial tribunal should find any provision of this agreement to be unenforceable, all other provisions shall remain in full force and effect.
I make this agreement in good faith, without mental reservation or purpose of evasion.
Printed Name Date
VDOT District/Division OR Company Name Phone Number
Company Address
Signature Signature of Authorized Agent (Not required for VDOT employees)
PART B: To Be Completed By Company Agent Only:
In addition to the provisions above, I certify:
All employees of this company involved with this VDOT project, regardless of location, who will have access to CII/SSI, myself included, will complete Part A of the Critical Infrastructure Information/Sensitive Security Information Multi-Purpose Non-Disclosure Agreement. The Agreement will be signed by me and accepted by VDOT prior to being granted access to CII/SSI. We will only access CII/SSI for which we have a need-to-know.
We will safeguard the confidentiality of all CII/SSI at all times. We will conduct ourselves in strict conformance to applicable laws and VDOT policies governing CII/SSI. Obligations with respect to the confidentiality and security of all CII/SSI disclosed to us shall survive the termination of any agreement or relationship with VDOT.
Authorized Company Agent:
Signature of Authorized Agent Date
Printed Name Title
Company Name Phone Number
Company Address
VDOT Contract Name and Number
This form is valid for the identified project for a period of two years, while employed by the same company.
Critical Infrastructure Information/Sensitive Security Information (CII/SSI) Multi-Purpose Non-Disclosure Agreement
Back Page
Retain a copy of both the front and back sides of this form for future reference.
Handling CII/SSI
You are responsible for safeguarding Critical Infrastructure Information/Sensitive Security Information (CII/SSI) in your custody or under your control.
The extent of protection afforded CII/SSI shall be sufficient to reasonably foreclose the possibility of its loss or compromise.
The terms of this clause (Handling CII/SSI), including this paragraph, must be included in any dissemination of any document, in whole or in part, that contains CII/SSI.
Protection - CII/SSI shall be protected at all times, either by appropriate storage or having it under the personal observation and control of a person authorized to receive it. Each person who works with protected CII/SSI is personally responsible for taking proper precautions to ensure that unauthorized persons do not gain access to it.
Use and Storage - During working hours, reasonable steps shall be taken to minimize the risks of access to CII/SSI by unauthorized personnel. After working hours, CII/SSI shall be secured in a secure container, such as a locked desk, file cabinet or facility where contract security is provided.
Reproduction - Documents or material containing CII/SSI may be reproduced to the minimum extent necessary consistent with the need to carry out official duties provided that the reproduced material is marked and protected in the same manner as the original material.
Disposal - Material containing CII/SSI shall be disposed of by any method that prevents unauthorized retrieval (e.g. shredding, burning, returning to original source, etc.).
Transmission - CII/SSI shall be transmitted only by VDOT courier, US first class, express, certified or registered mail, or through secure electronic means.
ITD-36E VDOT Information Security Agreement
I, _________________________________, acknowledge that I have been granted access to the automated systems, including licensed software, hardware, and data of VDOT and the Commonwealth of Virginia (COV).
I further acknowledge that the data contained in and accessed using the information systems and network of VDOT and any other automated system which I use in the course of performing my duties is the property of the Commonwealth of Virginia. This includes all systems and data used, regardless of where the system or data resides, to conduct business with VDOT. Although I have access to data, I shall not read or access information or data that is not needed to perform my duties. I shall not disclose or otherwise make available, in whole or in part, VDOT or COV information and data other than to other employees, consultants or business partners of (VDOT) to whom such disclosure is authorized, except as provided by law. Such disclosure shall be in confidence for purposes specifically related to the business of VDOT and COV.
I agree that logon IDs and passwords are not to be shared. If anyone asks for my password, I shall not provide it;
and I agree to report it to my manager and VDOT Information Security Team.
I understand and agree that computer resources and equipment that are the property of VDOT or COV are to be used for official business only, and not for personal use. I understand that VDOT and COV reserve the right to monitor access and disclose at their discretion any activity, data, or files within VDOT and COV systems. Therefore, I should have no expectation of privacy. I also understand it is my responsibility to protect the data and systems from damage or destruction, both tangible and intangible.
I shall take all appropriate action, whether by instruction, agreement or otherwise, to ensure the protection, confidentiality, and security of the information and automated systems. I will report all violations of information security immediately to the VDOT Information Security Team.
I agree that my obligations with respect to the confidentiality and security of all information and data disclosed to me shall survive the termination of this agreement, relationship, or employment with VDOT or COV.
Each provision of this agreement is severable. If any administrative or judicial tribunal should find any provision of this agreement to be unenforceable, all other provisions shall remain in full force and effect.
NOTE: Digital signatures are acceptable as long as the signature validates. If the signature does not validate then we will not be able to accept your forms and you will be asked to resubmit them.
ACKNOWLEDGED:
Name (Print)
Signature Date
Supervisor or VDOT Business Coordinator Date
VDOT Approver Date
Virginia Department of Transportation Rev 8/8/11
LD-899
(11/12/21)
LOCATION AND DESIGN DIVISION PROJECTWISE SYSTEM ACCESS REQUEST
(Please type or print legibly)
ALL ITEMS MUST BE FILLED IN. INCOMPLETE FORMS MAY BE DELAYED OR RETURNED.
User Name: __________________________________ Signature: __________________________ Date: ____________
Firm Name: _______________________________________________________________________________________
Street Address or P.O. Box: __________________________________________________________________________
City: _________________________________________________________ State: ______ Zip Code: ____________
E-mail Address: ________________________________________________ Phone: ___________________________
Supervisor Name: _____________________________ Signature: __________________________ Date: ____________
User Type (Check one - Required):
☐ Contractor ☐ Consultant ☐ Locality Employee
ProjectWise Access (Check one - Required):
☐Read-Only ☐Read-Write ☐No access
ProjectWise Deliverables Management (PWDM) Access (Check one - Required):
☐Yes ☐No
Critical Infrastructure Information (CII) Access (Check one - Required):
☐Yes (COV network account required) ☐No
TO ACQUIRE ACCESS TO CRITICAL INFRASTRUCTURE INFORMATION (CII), FOLLOW THE INSTRUCTIONS FOUND AT THE
FOLLOWING LOCATION:
https://www.virginiadot.org/business/resources/const/CII_SSIGuideV6.0InterimRevisionFINAL.PDF
A CURRENT ITD-36E SECURITY AGREEMENT MUST BE COMPLETED FOR EACH PROJECTWISE USER, WHICH MAY BE FOUND AT THE FOLLOWING LOCATION: http://vdotforms.vdot.virginia.gov/SearchResults.aspx?strFormNumber=ITD- 36E
Request Comments:
https://www.virginiadot.org/business/resources/const/CII_SSIGuideV6.0InterimRevisionFINAL.PDF http://vdotforms.vdot.virginia.gov/SearchResults.aspx?strFormNumber=ITD-36E http://vdotforms.vdot.virginia.gov/SearchResults.aspx?strFormNumber=ITD-36E http://vdotforms.vdot.virginia.gov/SearchResults.aspx?filename=ITD_36E%20VDOT%20Information%20Security%20Agreement.pdf
NOTES:
Verifiable digital signatures may be accepted in lieu of a wet signature.
Each ProjectWise user requires an individual account approved by an authorized officer of the firm (or the user’s supervisor).
Notifications will be made via e‐mail as soon as account requests are completed. You will need to check with your IT department to ensure that the CADDSupport@vdot.virginia.gov isn’t blocked.
COV domain accounts may take up to five business days.
Contractor/Consultant accounts may take up to 2 – 5 business days.
Please send completed forms to the CADD Support Desk at CADDSupport@VDOT.Virginia.gov.
If you have any questions regarding access to ProjectWise, please call the CADD Support Desk at (804) 786-1280 or call the toll free number (888) 683-0345.
Location and Design Division Use Only
VDOT Coordinator’s Name: __________________________________________________________________________
Date Received: _____________________________ Date Submitted to SARA: __________________________________ mailto:CADDSupport@vdot.virginia.gov mailto:CADDSupport@vdot.virginia.gov
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| I,: |
| Name (Print: |
| Date: |
| User Name: |
| Firm Name: |
| Street Address or P: |
| O: |
| Box: |
| City: |
| State: |
| Zip Code: |
| E-mail Address: |
| Phone: |
| Supervisor Name: |
| Consultan: |
| Locality Employe: |
| Contractor: |
| Read-Only: |
| Read-Write: |
| No acces: |
| Yes: |
| Yes COV network account required: Off |
| N: |
| Request Comments: |
| No COV network account required: Off |
| VDOT Coordinator’s Name: |
| Date Received: |
| Date Submitted to SARA: |
File details come from the government source that posted it. Updated .