Attachment D - Bid Submittal Form.docx
DOCX document 33 KB Posted
- Attached to
- 2022 Compressed Laboratory Gases
- Solicitation number
- S-44000-00003475
- Issued by
- Multnomah County, Oregon
About this file
This document is an Attachment D - Bid Submittal Form for ITB #S-44000-00003475, issued by the Oregon Department of Consumer and Business Services, Oregon Occupational Safety and Health. The contract opportunity is for the provision of compressed laboratory gases, including Acetylene, Air, Argon, Helium, Hydrogen, Nitrogen, and Nitrous Oxide, to Marion County and the City of Salem. The Agency is requesting pricing on the listed items, with the option to add or remove items as needed. Bids must meet or exceed the specifications outlined in Section 1.2 of the ITB. Pricing must remain firm for the first two (2) years of the contract.
The bid form requires bidders to provide unit pricing and total costs for each product, as well as delivery and hazmat charges, and monthly rental costs for various cylinder sizes. Bidders must also provide information about their company, such as contact details, federal ID, and COBID certification (if applicable). The bid must be signed by an authorized representative, and the bidder must acknowledge compliance with the terms and conditions of the ITB.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B - Bid Cover Sheet.DOCX | DOCX document | |
| ITB S-44000-00003475 Question and Answer.docx | DOCX document | |
| Attachment A - Sample Contract.docx | DOCX document | |
| Attachment C - Reference Check Form.DOCX | DOCX document | |
| Attachment F - Responsibility Inquiry.docx | DOCX document | |
| Attachment E - COBID Certification.docx | DOCX document | |
| Revision 2_ITB S-44000-00003475 - 2022 Compressed Lab Gases~1.pdf | ||
| Additional Product Information.pdf |
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Text version
ITB #S-44000-00003475 Att D
ATTACHMENT D
BID SUBMISSION FORM
Company Name: ___________________________________________________________________________________ Contact Person: ___________________________________________Title:_____________________________________ Address: ____________________________________________________________________________________________ Telephone: ____________________________Email:____________________________________________________ Federal ID #:__________________________ Oregon Secretary of State Registry #_____________________ COBID CERT# (if applicable) __________________________________________________________________
Each bidder must submit this Bid Form. The Bid Form should be signed and submitted to the SPC prior to Closing.
Award will be made to the lowest responsive and responsible Bidder for the average total cost of all items.
Agency is requesting pricing on the items listed in the following table. Table represents Agency’s anticipated needed items but reserves the right to add new items or remove items as needed. Pricing must remain firm for the first two (2) years of the Contract.
All bids must meet or exceed the specifications included in Section 1.2 of ITB
QTY
PRODUCT
UNIT OF MEASURE
DESCRIPTION & APPROXIMATE TANK SIZE
PRICE
| EA |
| ACETYLENE |
| Cubic foot |
| ACETYLENE 99.6% AA, A5 360 CU FT |
| EA |
| AIR |
| Cubic foot |
| AIR ULTRA ZERO, T |
310 CU FT
| EA |
| ARGON |
| Cubic foot |
| ARGON INDUSTRIAL, T 335 CU FT |
| EA |
| HELIUM |
| Cubic foot |
| HELIUM 99.999% UHP, T 291 CU FT |
| EA |
| HYDROGEN |
| Cubic foot |
| HYDROGEN 99.999% UHP T 260 CU FT |
| EA |
| NITROGEN |
| Cubic foot |
| NITROGEN 99.999% UHP T 304 CU FT |
| EA |
| NITROUS OXIDE |
| Pound |
| NITROUS OXIDE 99.998% SP T 73 LB |
| EA |
| DELIVERY |
DELIVERY CHARGE
| EA |
| HAZMAT |
HAZMAT CHARGE
CYLINDER RENTAL: Provide Monthly Rental Costs
| Provide cost for Cylinder Size similar to: |
| Monthly Rental charges |
12.5 inch dia x 41 inches tall
9.25 inch dia x 55 inches tall
9.25 inch dia x 50 inches tall
9.25 inch dia x 55 inches tall
SIGNATURE OF BIDDER’S DULY AUTHORIZED REPRESENTATIVE
I, the undersigned, agree to be bound by the form of Agreement and all remaining contract documents, including instructions to Bidders; Standard Terms and Conditions; Special Conditions; Federal Provisions, if applicable; and Specifications.
I, the undersigned, certify compliance with State of Oregon statutory requirements governing registration of corporations and assumed business names.
I, the undersigned, certify that this bid has been arrived at independently and has been submitted without any collusion designed to limit independent bidding or competition. I, the undersigned duly authorized representative of the bidder, understand that the bid must be signed by the bidder and that any alterations or erasures must be initialed in ink by the person signing the bid. Further, I acknowledge that I have read and understand all bid instructions, specifications, terms and conditions,(including the attachments indicated above) and agree, on behalf of myself and the bidder to be bound by them.
I the undersigned, duly authorized representative of the bidder, certify that the information provided in this bid is true and accurate. Further, I understand and acknowledge that providing incorrect information may cause for bid rejections or contract termination.
Name of Authorized Representative: ___________________________________________________________ Title: _______________________________________________________________________________________________ Signature: _____________________________________________ Date:____________________________________
File details come from the government source that posted it. Updated .