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 Report (RFI) template used by the District of Columbia Department of Public Works (DPW) for federal contracting purposes. The form serves as a structured mechanism for contractors and stakeholders to request clarification or propose solutions regarding contract execution issues during project performance.
The RFI template captures essential administrative information including contract title, number, RFI number, date, prime contractor identification, and the requesting party. Contractors must identify the specific Statement of Work (SOW) paragraph number and feature of work related to their inquiry, then describe the problem or issue requiring resolution. The form includes a checkbox section to indicate the nature of impact: potential cost impact, schedule impact, other impacts, or no cost change. Contractors propose solutions in a designated section and provide their signature and date. The form establishes a mandatory response deadline. The COR (Contracting Officer's Representative) section includes approval checkboxes from Safety, NEC, Fire Department, Master Planning, and Environmental stakeholders. The COR must indicate whether the proposed solution is accepted, rejected, or requires recommendation, with signature and date required for authorization. This template facilitates systematic documentation and multi-disciplinary review of contractor requests during contract performance with DPW.
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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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