ATTACHMENT B CONTRACT PRICE FORM.pdf

A T T A C H M E N T B C O N T R A C T P R I C E F O R M P a g e 1 o f 2

This form is to be completed in its entirety, is not to be altered in any way and is to contain only the price or prices stipulated on the form.

State Highway Administration IFB No.: 70EMGEN30SB Vendor Name:

Date of Bid:

Column A Column B Column C Column D

Item / Description Quantity

(See Note a)

Vendor’s Bid per Unit

Total Cost ($) (Column B x C)

#1001 - Service Call (No other fees, mileage or charges allowed)

15 Each

$______Each

#1002 - Technician – Routine Hourly Rate 120 Hours

$ Hours

#1003 – Labor (Helper) – Routine Hourly Rate 15 Hours

$ Hours

#1004 – (1) Dayton Maintenance Facility Scheduled Services, Maintenance, Inspection, Load Test & Operations Test is All Inclusive, to include all parts, labor, testing, transportation & equipment, performed once a year in the fall. (No Service Call Fee for this line item)

3 Each

$ Each

#1005 – (2) Jessup Maintenance Facility Scheduled Services, Maintenance, Inspection, Load Test & Operations Test is All Inclusive, to include all parts, labor, testing, transportation & equipment, performed once a year in the fall. (No Service Call Fee for this line item)

3 Each

$_______Each

Parts and/or Equipment (NOTE: Bid is percent to be added on the actual cost of supplies purchased by the Contractor. (For Example: Estimated Quantity is $2,500.00 x bid percentage of 5% = unit price is $125.00. $125.00 Unit price + $2,500 = $2,625.00 total line item cost) Percentage amount shall not exceed 10%

$2,000.00 estimated

________% x

$2,000.00 estimated =

($2,000.00 + unit price (% mark-up total amount)) =

TOTAL BID AMOUNT (Sum of Column D) (See Note b)

NOTE:

a ) Qu an t i t i e s a re e s t ima t ed an d u sed fo r b id ev a lua t i o n o n ly . Th ey may no t rep re sen t t h e ac tu a l q uan t i t ie s ex p e r i en ced o n ce th e co nt rac t i s award ed .

MDOT SH A, i s ex empt fro m Ma ry la nd Sa l e s a nd Use Ta x es by Ex empt io n Cer t i f i ca t e Number 3 0 0 0 2 5 6 -3 a nd fro m Federa l Ex c i se Tax es by Ex empt io n Number 5 2 -7 3 -0 3 5 8 K. Do no t inc lude ta x in b id pr i ce s

A T T A C H M E N T B C O N T R A C T P R I C E F O R M P A G E 2 O F 2

7 0 E M G E N 3 0 S B

Submitted by:

Signature of Authorized Representative Date

Printed Name and Title:

Telephone:

Email address:

Bidder Company Name:

Bidder Company Address:

Location(s) from which goods/services will be provided/performed (City/State):

FEIN:

eMMA #:

Quantity