Attachment_A_Proposal_Form.pdf
PDF 59 KB Posted
- Attached to
- RFP_MID_ODOT_Uility_Relocation
- Solicitation number
- S-Q10026-00018175
- Issued by
- Oregon
About this file
This is a Proposal Form/Signature Page for RFP-2026-02 issued by the Medford Irrigation District (MID) in Central Point, Oregon, in conjunction with the Oregon Department of Transportation (ODOT) for reimbursable utility relocation work associated with the Griffin Creek Bridge project (K23548-OR238). The solicitation requires proposers to submit proposals by November 9, 2026, at 4:30 p.m. The proposal must remain valid for ninety days from the due date. Proposers must acknowledge receipt of all issued addenda and certify their understanding of the full scope of work, ODOT and federal compliance requirements including 23 CFR Part 645 and Buy America provisions, and evaluation criteria.
Proposers must certify that they possess legal authority and financial capability to perform the work, that all proposal information is accurate and complete, and that they are not debarred or suspended from federal, state, or local contracts. The proposal form requires certification that no reimbursable preliminary engineering or construction work may commence until the District receives written Notice to Proceed from the ODOT State Utility Liaison. Proposers must also comply with all applicable federal, state, and local laws, including non-discrimination requirements and Buy America provisions for permanently incorporated iron and steel. The authorized signatory of the proposing firm must execute the proposal form, with corporate officers required to sign if the proposer is a corporation, and evidence of authority must be attached if requested.
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Text version
MEDFORD IRRIGATION DISTRICT
RFP-2026-02 | Reimbursable Utility Relocation Work | K23548-OR238
ATTACHMENT A — PROPOSAL FORM / SIGNATURE PAGE
PROJECT IDENTIFICATION
RFP Number: RFP-2026-02
Project / Highway: K23548-OR238 Griffin Creek Bridge – MID Relocation
Proposal Due Date: November 9, 2026, 4:30 p.m.
Issuing Agency: Medford Irrigation District, Central Point, Oregon
1. PROPOSER INFORMATION
Legal Name of Firm: _______________________________________________
DBA / Trade Name (if different): _______________________________________________
Mailing Address: _______________________________________________
City, State, ZIP: _______________________________________________
Physical Address (if different): _______________________________________________
Primary Contact Name & Title: _______________________________________________
Phone: ____________________ Email: ____________________
Federal Tax ID / EIN: ____________________ Oregon CCB # (if appl.): ____________________
2. ACKNOWLEDGMENTS AND CERTIFICATIONS
By signing below, the undersigned authorized representative of the Proposer hereby certifies and acknowledges the following:
☐ 1. The Proposer has carefully reviewed the entire Request for Proposals (RFP-2026-02), including all attachments, and fully understands the scope of work, ODOT/Federal compliance requirements (including 23 CFR Part 645 and Buy America), evaluation criteria, and submission requirements.
☐ 2. The Proposer acknowledges receipt of all addenda issued for this RFP (list addenda numbers received, or write “None”):
☐ 3. The Proposal is a firm offer and shall remain valid for a period of ninety (90) days from the Proposal Due Date.
☐ 4. The Proposer has the legal authority and financial capability to perform the services described in the RFP if selected.
☐ 5. All information contained in this Proposal is true, accurate, and complete to the best of the Proposer’s knowledge.
☐ 6. The Proposer is not currently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any federal, state, or local agency.
☐ 7. The Proposer understands that no reimbursable Preliminary Engineering or Construction work may begin until the District has received written Notice to Proceed from the ODOT State Utility Liaison (or authorized designee).
☐ 8. The Proposer agrees to comply with all applicable federal, state, and local laws, including non-discrimination requirements and Buy America provisions for permanently incorporated iron and steel.
3. AUTHORIZED SIGNATURE
The undersigned is authorized to bind the Proposer to the terms of this Proposal and any resulting contract.
Signature: ________________________________
Printed Name: _____________________________
Title: ____________________________________
Date: _____________________________________
Firm Name: _______________________________
Phone: ___________________________________
Email: ___________________________________
Note: If the Proposer is a corporation, the signature must be that of an officer authorized to bind the corporation. Attach evidence of authority if requested. Corporate seal may be affixed if available.
Submit this completed and signed form as the first page (or immediately following the Cover Letter) of the Proposal package.
Attachment A – Proposal Form / Signature Page Page 1
File details come from the government source that posted it. Updated .