Attachment_5_Forms_to_Return_with_Quote_ONPVC_Sewer.docx

PRICE SCHEDULE

The contractor shall factor the lump sum price to include all labor, tools, equipment, materials, mobilization-in, mobilization-out, insurance, contract administration, project management, overhead and profit (applicable to prime contractor and any subcontractors) necessary for completing all work. All work shall be performed in accordance with the awarded contract terms and clauses, including the attached Dept. of Labor Davis-Bacon Act wage rates and project specifications delineated in the Statement of Work (SOW).

The Quoter shall submit a price for the line item below. Failure to do so may render the quote ineligible. For the priced line item, provide the total price only. Round totals to whole dollars. Award will be made to one contractor in accordance with Sections L and M.

Complete this page and return with other documents described in Section L.

#00010 OLYM 10 linear feet sewer repair

Lump Sum

Option Item One OLYM Additional 10 linear feet sewer repair and concrete restoration

Lump Sum

TOTAL PRICE (Base Item)

TOTAL PRICE (Base Item plus all option items)

Business Name:

Address:

SAM UEI:

Phone:

Submitted by – Printed Name:

Submitted by – Signature:

Date:

RELEVANT EXPERIENCE:

CONTRACTOR’S PROPOSED TEAM:

Do you plan to self-perform all the work?

(YES or NO)

Are you proposing to use a subcontractor?

(YES or NO) If YES, complete information below:

Subcontractor Company Name, POC name, address, email, and phone number:

List any proposed subcontractor(s) and indicate what key trade they may be assigned to perform:

If you are proposing to use a subcontractor, describe what work activities you plan to self-perform:

LIST OF RELEVANT EXPERIENCE (LIST OF PROJECTS) & PAST PERFORMANCE REFERENCES FOR PRIME CONTRACTOR:

Experience/Reference #1

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

Experience/Reference #2

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

Experience/Reference #3

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

LIST OF RELEVANT EXPERIENCE (LIST OF PROJECTS) & PAST PERFORMANCE REFERENCES FOR SUBCONTRACTOR:

Experience/Reference #1

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

Experience/Reference #2

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

Experience/Reference #3

Project Title:

Contract # (if known):

Agency/Owner:

$ Amount:

Performance Period:

Briefly describe how this project is similar in nature and scope to current advertised requirement:

Past Performance Reference (Name & Title):

Past Performance Reference Phone:

Past Performance Reference Email:

Technical Approach Provide a brief work plan describing your approach to the project that demonstrates your understanding of the requirements and the capabilities and experience you bring to it. Include, for example, number of workers (by job classification) and tentative work schedule, phasing the work, equipment you expect to use. PLEASE NOTE: A simple restatement of the requirements outlined in the SOW is not acceptable and may render the quote ineligible.

K.2 This section requires contractor to fill in highlighted boxes and submit with quote.

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision— Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(ii) For covered services—

(i) For covered equipment—

(ii) For covered services—

52.204-26 Covered Telecommunications Equipment or Services – Representation (OCT 2020)

(a) Definitions. As used in this provision, "covered telecommunications equipment or services" and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(c)

(1) Representation. The Offeror represents that it ☐ does, ☐ does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it ☐ does, ☐ does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.