2-26-025 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 for Walworth County, Wisconsin, related to the Kitchen Worktable Replacement project for Lakeland Health Care Center and the Sheriff's Office. The form serves as a template and submission document for contractors and bidders to request approval of substitute products or materials in place of those specified in the project specifications. The project involves furnishing and installing up to five stainless steel kitchen worktables of varying dimensions, which may include built-in sinks, spray and fill assemblies, electric heaters, and disposals.
The substitution request form requires submitters to identify the specification section affected, provide drawings and details, and explain the proposed substitution including manufacturer and product details. Submissions must indicate whether the request is a pre-bid substitution (requiring prior approval before the bid date) or submitted for other reasons such as product unavailability or cost savings. The form requires submitters to analyze the effects of the substitution on project dimensions, other work sections, and design requirements. All contractors and bidders must accept responsibility for coordination of the proposed substitution and any additional costs resulting from its incorporation. The form is submitted to Carolyn Holt, Senior Buyer, and requires review and approval with documented comments before acceptance or rejection.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-26-025 - RFB - Final.pdf | ||
| 1-26-025 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 .