5-IFB Vol. 3(1) Solicit Offer Form BT.pdf

Madison County Mass Transit District IFB Volume 3 of 5

Solicitation and Offer Form

SOLICITATION

1. Bid Title:

2. Bid No:

3. Firm Offer Period: Offers submitted shall remain firm for a period of 90 calendar days from the final due date for bids.

4. NOTE: “Offer” and “offeror” mean “bid” and “bidder”.

5. MCT has established a % DBE goal for this project.

OFFER

(to be completed by Bidder)

6. Bidder/Contractor Name:

7. Mailing Address: 8. Telephone Number:

9. City - State - Zip 10. Fax Number:

11. Organization is: (check one) Corporation Sole Proprietorship Partnership Quasi-Public Agency

Public Agency Joint Venture

LLC

Other, specify ________

12. Bidder’s annual gross receipts:

Less than $500,000 $500,000 - $1,000,000 $1,000,000 – $2,000,000 $2,000,000 – $5,000,000 More than $5,000,000

13. Number of people employed on a regular basis:

14. Number of years in business

15. SAM.gov unique entity

ID

16. Dun and Bradstreet # (DUNS)

17. Is the bidder presently certified as a Disadvantaged Business Enterprise (DBE) by the Illinois Unified Certification Program (UCP) according to the type of work/services called for in this solicitation? YES NO

18. Bidder acknowledges receipt of the following addenda to the solicitation:

Addendum # and Date of Issue Addendum # and Date of Issue

19. The undersigned agrees, if this offer is accepted by the Madison County Mass Transit District, to furnish any or all items and provide the services upon which a price is offered, and to deliver the items, perform the services, and complete the work within the time specified.

20. Total Bid Price:

Do not enter price here.

Use the Bid Price Form (electronic bid table).

21. Name of authorized signer: (Type or print)

22. Title:

23. Bidders Signature:

24. Date:

Solicitation and Offer Form