Attachment_1_-_Product_Offerings_Worksheet.pdf

DOILFBO220026 Product Offerings Worksheet 1

A. Product Offerings In the table below, check the box to indicate which product offerings your company offers; in the column at right, state the location where the product may be picked up. (Government shall pick up products;

delivery is not required). If multiple pickup locations are possible, please use the continuation sheet.

Note: it is not necessary to offer all products from the list below to be considered for a Blanket Purchase

Agreement; please provide all requested information (including complete address in column c and batch mix reports in column d.) for only those products your company offers. Failure to provide a batch mix report for a given product will impact your ability to receive a BPA.

Contractor name: _______________________________________

Address: ______________________________________________

Unique Entity Identifier (UEI):_________________

____Initial here to affirm your company has an active profile at www.sam.gov:_________________________

____Initial here to affirm your company is willing to maintain an active profile at www.sam.gov at BPA award, through performance, and through final invoicing. No invoice shall be paid if your firm has an inactive profile at www.sam.gov.

Printed name of authorized company representative:________________________________

Signature of authorized representative:___________________________________________

____Initial here to confirm acceptance invoicing terms: All invoicing for orders issued under any BPA issued from this notice to your firm shall be submitted via the online invoicing platform of the Dept. of Interior, www.ipp.gov.

Prompt payment within 30 days after acceptance of a valid invoice shall apply to all orders.

a. b. c. d.

Product Description Does your company offer this product?

Y/N

Name of Batch Plant/ Quarry and Address where product may be picked up by government staff:

Have you attached a batch mix report showing that product meets the specification in the Statement of Work ? Y/N

Hot mix asphalt concrete, ODOT Class C, ½” Dense, Level 3

Name:__________________________

Address:________________________

Catonic Emulsified Asphalt (Asphalt Tack Coat)

B. Special Terms State whether a minimum unit qty. is required per order; if catalogue or tiered discount pricing is available, please provide price per ton and any discounts offered for bulk orders.

Hotmix Asphalt Concrete:

Minimum order qty. (in tons):_____________ Maximum order qty. (in tons):_____________

Catonic Emulsified Concrete (Tack Coat):

Minimum order qty. (in tons):_____________ Maximum order qty. (in tons):_____________

Discounted and or seasonal pricing terms (if applicable):___________________________

DOILFBO220026 Product Offerings Worksheet 2

Response time (state how much notice do you need to be able to fulfill a pickup order?) _____days or ____ hours.

C. Price Reasonableness: A published pricelist is requested with your submission, if available. If a published pricelist is not available, check here (use X) _____to affirm that all prices offered for BPA calls /orders would not exceed pricing offered to your best customers at the time ordered and would be considered fair and reasonable to a reasonable person placing an order for such supplies.

DOILFBO220026 Product Offerings Worksheet 3

PRODUCT OFFERINGS WORKSHEET – Continuation (only use this sheet if your company offers multiple pickup locations for supplies):

a. b. c. d.

Product Description Does your company offer this product?

Y/N

Name of Batch Plant/ Quarry and Address where product may be picked up by government staff:

Have you attached a batch mix report showing that product meets the specification in the Statement of Work ? Y/N

Hot mix asphalt concrete, ODOT Class C, ½” Dense, Level 3