6110 Form.pdf

CONTRACTOR’S RESPONSE TO

REQUEST FOR PROPOSAL

PROJECT TITLE BID DUE DATE

CONTRACTOR NAME

CONTRACTOR ADDRESS

PHONE NUMBER

PERSONNEL INFORMATION:

ALL BIDDERS MUST BE MAINTENANCE PREQUALIFIED IN THE APPROPRIATE CATEGORY AND MEET THE REQUIREMENTS OF THE PREQUALIFICATION PROGRAM. IF ANY CHANGES HAVE OCCURRED THAT COULD IMPACT THE

PREQUALIFICATION, PLEASE DESCRIBE THEM BELOW.

QUALIFIED SERVICE-DISABLED VETERAN: YES NO

CONTRACTOR’S PROGRAM MANAGER

NAME PHONE NUMBER E-MAIL ADDRESS

FOR PROJECTS IN CATEGORY 4, TREE CUTTING/TRIMMING, PROVIDE COPIES OF LICENSES AND CERTIFICATIONS FOR

STAFF INVOLVED IN THE PROJECT.

DO YOU INTEND TO USE ANY SUBCONTRACTOR(S) ON THIS PROJECT? YES NO

IF YES, SUBCONTRACTOR MUST BE MDOT CONSTRUCTION PREQUALIFIED FOR ALL TASKS EXCLUDING TREE

REMOVAL/TRIMMING SERVICES.

PLEASE LIST THE NAME OF THE SUBCONTRACTOR (S) AND THE EXTENT OF THE WORK THEY WILL BE DOING ON THIS

PROJECT.

PRICING:

SUBMIT PROJECT PRICING THROUGH THE SIGMA SYSTEM AND FILL OUT THE PRICING DETAIL SHEET.

DESCRIBE ANY APPLICABLE DISCOUNTS AVAILABLE.

E-MAIL ADDRESS

Michigan Department of Transportation

6110 (01/19)

PLEASE LIST THE NAMES OF ALL STAFF DEDICATED TO THIS PROJECT AND THEIR ROLES.

EVALUATION:

THE BID WILL BE AWARDED TO THE MDOT MAINTENANCE PREQUALIFIED BIDDER WHO MEET SPECIFICATIONS AS DETERMINED BY THE STATE AND OFFERS THE LOWEST PRICE TO THE STATE. BID EVALUATION WILL INCLUDE

PREFERENCES FOR PROPOSALS FROM QUALIFIED SERVICE-DISABLED VETERANS.

I HAVE READ AND AGREE TO PERFORM THE WORK SET FORTH IN THE WORK STATEMENT FOR BID # ___________ AND SUBMIT THE ABOVE PROPOSAL IN ACCORDANCE WITH ALL OF THE TERMS AND CONDITIONS OF THE CONTRACT I HOLD

WITH THE STATE OF MICHIGAN.

THIS BID IS VALID FOR 30 DAYS FROM THE DUE DATE LISTED ON THE STATEMENT OF WORK AND PRICING IS VALID FOR

_________ DAYS FROM THE DATE THE PURCHASE ORDER IS ISSUED.

NAME PRINTED OR TYPED

SIGNATURE DATE

Page 2 of 2 MDOT 6110 (01/19)