2026-RFP-175-_00_41_00_-_USER-Bid_Form.pdf

Division 00 - Procurement and Contracting Requirements Proposal Form

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PROPOSAL FORM

PROPOSER REGISTERED NAME: ________________________________________________

PROPOSAL DATE: ________________________________________________________________

Having carefully examined all drawings & specifications prepared by Pierce County, as well as the premises and conditions affecting the work, the Undersigned proposes to furnish all labor, equipment, and materials and perform all work for this project in accordance with the drawings, specifications, and addenda (if any), for the consideration of the following amounts. Please note: all items on the proposal form need to complete to be considered responsive.

Duris Cucumber Farm Item # Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

3 VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Local Color Farm Item # Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

3 VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Sidhu Farms Item # Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Sterino Farm Orting Item # Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

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VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Tahoma Farm Item # Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Wild Hare Farm Item Item Quantity Unit Total

1 Installation & Programing 1 LS $0.00

2 Testing & Training 1 LS $0.00

VFD Controller & Associated Material Costs 1 LS $0.00

Estimated Total Cost: $0.00

Estimated Grand Total Cost: $ *Sales tax will be paid on taxable amounts based on the rate of the location of service - NOT TO BE INCLUDED in proposal pricing.

EVALUATION OF PROPOSALS: In accordance with the provisions of these Contract Documents, Proposals will be evaluated to determine the best fit based on evaluation criteria.

AWARD: For the purposes of awarding the contract and determining responsible, responsive proposal, proposals are evaluated on the base proposal and any combination of alternates that the Owner chooses to exercise. Pierce County reserves the right to award base proposal and all or none of the alternates. It is anticipated that any alternate proposals for additional or related work will be accepted at the time contract award is made

ADDENDA: Proposer acknowledges review of all Addenda through No.

CONTACT INFORMATION:

FIRM: ______________________________________________________________________

ADDRESS: __________________________________________________________________

CITY: STATE: ZIP: ________

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NAME OF MAIN CONTACT FOR THIS PROPOSAL: _______________________________________

PHONE: _________________________________

EMAIL: _________________________________

SIGNATURE OF AUTHORIZED PERSON*: _________________

PRINT NAME & TITLE: _________________

DATE: ___________________________

*to determine 'authorized' person reference Division 00 'Instructions to Proposers

Complete the tax status information for one of the following business entity types. Individual or Corporate name must match exactly as registered with either Social Security Administration or Internal Revenue

Service.

Identification of Contractor as a sole proprietor, a partnership, a joint venture, a corporation, or another described form of legal entity: __________________________________________________________

Federal Tax ID# (EIN or SSN – as applicable): _____________________________________________

* If a corporation, proposer must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co-partnership, proposal must be executed by a partner.

THE FOLLOWING DOCUMENTS ARE TO BE SUBMITTED WITH THIS PROPOSAL FORM:

• Bidder Responsibility Information Form

• Bid Bond Form

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BIDDER RESPONSIBILITY INFORMATION FORM (TO BE SUBMITTED WITH

PROPOSAL):

State of Washington Contractor's License No:

Unified Business Identifier (UBI) No:

Employment Security Department No:

DEBARMENT: Proposer has not been disqualified from proposing on any public works contract under RCW

39.06.010 or 39.12.065? ☐ YES ☐ NO

PREVAILING WAGES TRAINING: Proposer has received training on the requirements related to public works and prevailing wage under chapter 39.04 and chapter 39.12 RCW or are exempt from the training per

RCW 39.04.350: ☐ YES ☐ NO

TITLE VI COMPLIANCE

Pierce County, in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d to 2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, subtitle A, Office of the Secretary, Part 21, nondiscrimination in federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all proposers that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, disadvantaged business enterprises as defined at 49 CFR Part 26 will be afforded full opportunity to submit proposals in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin in consideration for an award.

CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES

The proposer hereby certifies that, within the three-year period immediately preceding the proposal due date, the proposer is not a willful violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or

49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction.

I declare under penalty of perjury under the laws of the State of Washington that the statement regarding Certification of Compliance with Wage Payment Statutes is true and correct.

http://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 http://app.leg.wa.gov/RCW/default.aspx http://app.leg.wa.gov/RCW/default.aspx

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*SIGNATURE OF AUTHORIZED PERSON:

PRINT NAME & TITLE:

DATE:

*to determine ‘authorized’ person reference RCW 39.04.350(1)(g) / RCW 5.50