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BID SUBMISSION FORM
Business Identification
BUSINESS NAME:
ADDRESS:
CONTACT PERSON:
TITLE:
TELEPHONE NO.:
EMAIL ADDRESS:
REMITTANCE ADDRESS:
| PROMPT PAYMENT DISCOUNT: |
| ___% FOR PAYMENT WITHIN____ DAYS; NET___DAYS |
BUSINESS ORGANIZED UNDER THE STATE LAWS OF:
STATE CORPORATION COMMISSION IDENTIFICATION NO.:
PRODUCT BID (MAKE / MODEL #)
DELIVERY (DAYS AFTER RECEIPT OF ORDER):
Qualifications and References Type of work performed by this business:
Number of years this business has been in operation:
| Business License: |
| Type: |
| Issued: |
| List at least three state, county, or federal agencies or commercial references that the business contracted with in the past two years for a comparable procurement (include contacts and telephone numbers): |
| A) |
B)
C)
Authorized Signature By signing this quote bidder certifies, acknowledges, understands, and agrees to be bound by the conditions set forth in this Solicitation.
| Authorized Signature: |
| Date: |
| Email Address: |
| Telephone Number: |
PRICE FORM
· The Contractor shall provide a price that includes all labor, equipment, material, and surface preparation.
· Award shall be made to the lowest bidder(s) for line items 1 through 3. Line items 4 though 27 are optional and will not be considered in the award evaluation.
| ITEM # |
| ITEM DESCRIPTION |
| Quantity |
| UNIT |
| DAY RATE |
| TOTAL |
| 1 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 8” White |
| 3400 |
| LFT |
| $ |
| $ |
| 2 |
| Coating ONLY (Recoat Stamped Asphalt) |
| 16,700 |
| SQUARE FOOT |
| $ |
| $ |
| 3 |
| New Stamped and Color Coated Asphalt |
| 780 |
| SQUARE FOOT |
| $ |
| $ |
TOTAL
Time & Material Rates for services not listed above:
| Unit of Measure |
| Unit Price |
| 4 |
| Labor Rate (regular) |
| Hour |
| $ |
| 5 |
| Material (markup) |
| Percentage |
| % |
Response Time: days ARO
Paint (manufacturer/type):
· Optional Rates for Additional Services. The Contractor shall provide a price that includes all labor, equipment, material, and surface preparation.
· Nighttime rates. Extended time shall be approved by the Director of Public Works or appointee.
| ITEM # |
| ITEM DESCRIPTION |
| UNIT |
| DAY RATE |
| NIGHT RATE |
| 6 |
| Traffic Control |
| DAY |
| $ |
| $ |
| 7 |
| Lighting for Night Work |
| DAY |
| $ |
| $ |
| 8 |
| New Stamped Thermoplastic Asphalt |
| SQUARE FOOT |
| $ |
| $ |
| 9 |
| New Stamped and Inlaid Thermoplastic |
| SQUARE FOOT |
| $ |
| $ |
| 10 |
| New Flat Pattern Decorative Thermoplastic |
| SQUARE FOOT |
| $ |
| $ |
| 11 |
| MMA Pavement Coating in Bike Lane or Bus Lane |
| SQUARE FOOT |
| $ |
| $ |
| 12 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 4” White |
| LFT |
| $ |
| $ |
| 13 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 4” Yellow |
| LFT |
| $ |
| $ |
| 14 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 6” White |
| LFT |
| $ |
| $ |
| 15 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 12” White |
| LFT |
| $ |
| $ |
| 16 |
| Regulatory Preformed Thermoplastic Lines (Retroreflective & Anti-Skid): 24” White |
| LFT |
| $ |
| $ |
| 17 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 6’ White Sharrow Hump Symbol |
| EACH |
| $ |
| $ |
| 18 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 4’ Handicap Symbol with Blue Background |
| EACH |
| $ |
| $ |
| 19 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 39” Handicap Symbol White |
| EACH |
| $ |
| $ |
| 20 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 9ft Shared Lane Symbol White |
| EACH |
| $ |
| $ |
| 21 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 4ft x 10ft Shared Lane Symbol with Green Background |
| EACH |
| $ |
| $ |
| 22 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 6ft PreMark Bike Rider with Helmet |
| EACH |
| $ |
| $ |
| 23 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 8ft PreMark Bike Rider with Helmet |
| EACH |
| $ |
| $ |
| 24 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 6ft PreMark Bike Lane Straight Arrow |
| EACH |
| $ |
| $ |
| 25 |
| Regulatory Preformed Thermoplastic Symbols (Retroreflective & Anti-Skid): 9’6” Straight White Arrow |
| EACH |
| $ |
| $ |
| 26 |
| Thermoplastic Overlay (Overlay existing Stamped Thermoplastic) |
| SQUARE FOOT |
| $ |
| $ |
| 27 |
| Fire Hydrant/Lane Curb Painting – 6” wide 15’ long Red stripe with 4” white lettering stating “NO PARKING FIRE LANE” |
| EACH |
| $ |
| $ |