Attachment F - DPW-RFI Template Blank Form.pdf

PDF 2 MB Posted

Attached to
New Fort Bliss Paving IDIQ Contract
Solicitation number
W911SG27BA002
Issued by

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

File details come from the government source that posted it. Updated .