Attachment F - DPW-RFI Template Blank Form.pdf
PDF 2 MB Posted
- Attached to
- New Fort Bliss Paving IDIQ Contract
- Solicitation number
- W911SG27BA002
About this file
This document is a Request for Information (RFI) Report template used by the District of Columbia Department of Public Works (DPW) for contract administration purposes. The form serves as a standardized mechanism for contractors or stakeholders to request clarification or propose solutions regarding contract performance issues.
The RFI template captures essential contract identification information including the contract title, contract number, RFI number, date, and the prime contractor name. Contractors submit inquiries by referencing the relevant Statement of Work (SOW) paragraph number and feature of work, then describe the problem or issue requiring resolution. The form requires contractors to identify the potential impact of their inquiry across four categories: potential cost impact, schedule impact, other impacts, or no cost change. Contractors must propose a solution and provide a signature with date, with a designated response deadline specified. The form includes checkboxes for acceptance review by multiple stakeholder departments including Safety, Fire Department, NEC, Master Planning, and Environmental. The Contracting Officer's Representative (COR) reviews the submission and selects one of three responses: acceptance of the proposed solution, rejection of the proposed solution, or provision of a COR response to contractor questions. The COR must also provide a recommendation if needed and sign and date the document before finalization. This template facilitates structured communication and documentation of contract clarifications and modifications during performance.
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Text version
RFI No.
Date
Contract Title:
Contract No.
RFI Subject:
Prime Contractor: Requested by:
Feature of work
Date
Date
RFI requires answer no later than this date:
Contractor (stakeholder) Signature
COR Signature
Contractor (Stakeholder) Proposed Solution:
REQUEST FOR INFORMATION – REPORT (RFI)
Potentional cost Impact Schedule Impact Other No Cost change
Information Requested by Contractor (Stakeholder):
COR Accepts contractor proposed solution.
COR recommendation below
COR Rejects contractor proposed solution.
COR response to Contractor questions.
______________ Safety accepts proposed solution
______________ NEC accepts proposed solution
______________ Fire Department accepts proposed solution
______________ Master Planning accepts proposed solution
______________ Environmental accepts proposed solution
| Contract Title: |
| RFI No: |
| Contract No 1: |
| Contract No 2: |
| undefined: |
| Feature of work: |
| Date1_af_date: |
| Text3: Describe problem/Issue here |
| Text9: |
| Date10_af_date: |
| Date11_af_date: |
| Check Box16: Off |
| Check Box17: Off |
| Check Box18: Off |
| Date19_af_date: |
| Text1: |
| Text4: |
| Button5: |
| Dropdown1: [SOW Paragragh No.] |
| Text2: |
| Check Box2: Off |
| Text12: |
| Text13: Other accepts proposed solution |
| Text8: |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
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