161004_Fillable Forms.pdf
PDF 74 KB Posted
- Attached to
- UIFB# 161004 CMP & Bands
- Solicitation number
- QQ-121594
- Issued by
- Montgomery County, Virginia
About this file
This is a fillable bid form attachment document for the Virginia Department of Transportation (VDOT) solicitation #161004 for the procurement of Galvanized and Polymer Coated Corrugated Metal Pipe and bands for the Christiansburg Residency. The document serves as a standardized submission template for bidders responding to this solicitation. The forms require bidders to identify manufacturers and shipping points for each item offered, specify item numbers associated with bids, and provide documentation regarding plastic materials content in their products. The attachment structure accommodates multiple bid lines and items, allowing bidders to submit comprehensive information for various product offerings within a single standardized format.
The form includes sections for bidders to declare whether plastic materials contain recycled content and to specify the percentage of recycled content when applicable. Additionally, the document requires submission of normal and emergency contact information, including primary contact names, titles, mailing addresses, phone numbers for various times of operation, fax numbers, and email addresses. This contact section accommodates multiple contact persons within a single bidder's organization, enabling VDOT to maintain comprehensive communication channels throughout the procurement and contract performance phases. The fillable nature of these forms allows for efficient bid processing and ensures consistent data collection across all responsive proposals.
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Other files
| File | Type | Posted |
|---|---|---|
| 161004 Notice of Award | — | |
| 161004_Specifications.pdf | ||
| 161004 Q & A.pdf |
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Text version
ATTACHMENT ___
NAME OF MANUFACTURER AND SHIPPING POINT
Solicitation #: _____________
Each bidder shall supply in the space below the name and address of the manufacturer of each item offered and the shipping point.
BID LINE(S): _________________________________________________________
ITEM NUMBER(S):
MANUFACTURER:
ADDRESS:
SHIPPING POINT:
ATTACHMENT ____
PLASTIC MATERIALS RECYCLED CONTENT
Solicitation # ____________
Bidders must identify whether their plastic materials contain recycled materials and, if so, specify the amount of recycled content in such plastic materials.
☐ None of the materials offered contain plastic ☐ None of the plastic materials offered contain recycled materials ☐ Some or all of the plastic materials offered contain recycled materials. Specify the amount of recycled content below.
BID LINE(S): ______________________________________________________________________, if applicable
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
Type of Material: _________________________________ Amount of Recycled Content: __________________
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
Fax Number
E-mail Address
| ITEM NUMBERS: |
| MANUFACTURER: A |
| ADDRESS: |
| undefined: |
| SHIPPING POINT: |
| BID LINES_2: |
| ITEM NUMBERS_2: |
| MANUFACTURER_2: |
| ADDRESS_2: |
| undefined_2: |
| SHIPPING POINT_2: |
| BID LINES_3: |
| ITEM NUMBERS_3: |
| MANUFACTURER_3: |
| ADDRESS_3: |
| undefined_3: |
| SHIPPING POINT_3: |
| PLASTIC: B |
| Solicitation: 161004 |
| None of the materials offered contain plastic: Off |
| None of the plastic materials offered contain recycled materials: Off |
| Some or all of the plastic materials offered contain recycled materials Specify the amount of: Off |
| BID LINES: |
| Type of Material: |
| Amount of Recycled Content: |
| Type of Material_2: |
| Amount of Recycled Content_2: |
| Type of Material_3: |
| Amount of Recycled Content_3: |
| Type of Material_4: |
| Amount of Recycled Content_4: |
| Type of Material_5: |
| Amount of Recycled Content_5: |
| Type of Material_6: |
| Amount of Recycled Content_6: |
| Type of Material_7: |
| Amount of Recycled Content_7: |
| Type of Material_8: |
| Amount of Recycled Content_8: |
| Type of Material_9: |
| Amount of Recycled Content_9: |
| Type of Material_10: |
| Amount of Recycled Content_10: |
| CONTACTS: C |
| 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: |
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