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 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

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