(Rev. 11/03/25)

BID PROPOSAL

to the

STATE OF NEW YORK

DEPARTMENT of TRANSPORTATION

Purchasing, 50 Wolf Road

Suite 1PC, Albany NY 12232 Telephone (518) 457-4401

OR Email: ElectronicBidSubmission@dot.ny.gov (and must follow supplemental instructions) www.dot.ny.gov/business

─ Bid Proposals Due by 11:00 a.m. on 07/22/2026 ─

Invitation for Bids (IFB) Reference #BA26-010

Proposal Objective:

Portable Screener and RC Tracked Skid Steer

Name of Bidder (Company’s Complete Name)

Federal Employer Identification No. (FEIN) NY Vendor

ID No.

Bidder Contact Information Name & Title

Mr.

Ms.

Address

Telephone No.

Email Address Bidder’s Website mailto:ElectronicBidSubmission@dot.ny.gov http://www.dot.ny.gov/business

BE SURE YOU HAVE INSERTED

YOUR COMPANY’S COMPLETE

NAME IN THE BOX AT RIGHT

ALL BIDS MUST BE SUBMITTED USING THIS BID PROPOSAL FORM

Bidders are cautioned to make every effort to tender a fully-compliant offer. Bids which contain material deviations from the specifications or other provisions set forth in the IFB may, depending upon the nature of the deviation(s), be rejected as non-responsive.

If your bid deviates from any of the specifications, terms, and/or conditions set forth in the Invitation for Bids, you must check the box below and explain in a separate attachment with this Bid Proposal submission, labeled “Bid Deviation Attachment.” Otherwise, bid submissions will be deemed to be in full and complete compliance with the IFB.

CHECK ONLY IF BID DEVIATION ATTACHMENT INCLUDED W/ BID PROPOSAL

INSTRUCTIONS:

Use the chart on the following page to provide your Bid Proposal in response to Invitation for Bids BA26-010.

DESCRIPTION QUANTITY GRAND TOTAL BID AMOUNT w/ Options LOT 1 – Portable Screener - the bid price must include: training, installation, testing, warranty and all specs listed in the IFB 1

DESCRIPTION QUANTITY GRAND TOTAL BID AMOUNT w/ Options

LOT 2 – RC Tracked Skid Steer -the bid price must include:

training, installation, testing, warranty and all specs listed in the IFB 1

REQUIRED & OPTIONAL

BID SUBMISSION DOCUMENTS

√Checklist

REQUIRED

BID PROPOSAL FORM (this document) – IMPORTANT: MUST BE SIGNED FOR BID VALIDATION (see Bid

Proposal Validation)

BIDDERS WORKSHEET (Sign, and attach to the Bid Proposal-This document)

AMENDMENTS (if issued by NYSDOT applicable to this IFB)

MWBE UTILIZATION PLAN (see IFB page 9)

SDVOB UTILIZATION PLAN (see IFB page 9)

Exhibit A Forms/Questionnaires:

Procurement Lobbying Act - Offerer Certification and Attestation Form (see NYSDOT Purchasing Exhibit A Supporting Forms/Questionnaires)

Executive Order 177 Certification Form

Executive Order 16 Certification Form

Manufacturer’s Certification Form Complete if a contract for Commodities

NYS Sales and Use Tax Forms (ST-220-CA & ST-220-TD) (see NYSDOT Purchasing Exhibit A Supporting Forms/Questionnaires & IFB)

Vendor Responsibility Questionnaire (proof of certification if conducted online) (see NYSDOT Purchasing Exhibit A Supporting Forms/Questionnaires & IFB)

Affidavit of No Change Form

Complete if a Vendor Responsibility Questionnaire has been submitted to a State Agency within the past six months and no changes to the responses of this questionnaire are required

NYSDOL Registration for Public Work Projects Complete if Bid includes Prevailing Wage Requirement. Must be registered prior to submitting a Bid.

(see Contractor and Subcontractor Landing | Department of Labor)

Other Required Documentation:

Workers Compensation and Disability Benefits Certificates Coverage (proof of compliance) (see IFB)

Insurance (proof of insurance and required amounts)

(see IFB) https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fdol.ny.gov%2Fcontractor-and-subcontractor-landing&data=05%7C02%7CJessica.Owen%40dot.ny.gov%7C15bf842d472f49763bac08dd155ef481%7Cf46cb8ea79004d108ceb80e8c1c81ee7%7C0%7C0%7C638690219751883211%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=P0vZskDq%2FEntqf8m7zhLTZc2vDp1frjrY8hihQSlZRU%3D&reserved=0

OPTIONAL (Conditionally Required)

BID DEVIATION ATTACHMENT (only required to be submitted with Bid Proposal if bid will deviate from any of the specifications, terms and/or conditions set forth in the IFB - see IFB)

ELECTRONIC SIGNATURE AFFIRMATION (only required to be submitted if bid submitted electronically following supplemental instructions - see IFB)

Will New York State Businesses be used in the performance of this contract?

Yes No

If yes, identify below New York State businesses that will be used (Name and City of Supplier/s).

NAME of SUPPLIER (and/or Subcontractor) CITY (Location) of SUPPLIER

BIDDER IS REQUIRED TO FURNISH THE FOLLOWING INFORMATION AND

THEN CERTIFY AND VALIDATE THE BID PROPOSAL SUBMISSION

1. Are you a New York State Resident Business? Yes No

1(a). Are you Independently owned and operated? Yes No

2. How many persons does your company employ?

3. How many of those are employed in New York State?

4. Is your company a Minority and/or Women-Owned Business Enterprise (M/WBE), certified in accordance with Article 15-A of the NYS Executive Law (https://ny.newnycontracts.com/FrontEnd/VendorSearchPublic.asp) and/or a NYS Small Business Enterprise (SBE), self-certified in accordance with Finance Law 179-F, and/or a Disadvantaged Business Enterprise (DBE), certified in accordance with Title 49 Code of Federal Regulations Part 26 (http://osdbu.dot.gov/DBEProgram/index.cfm) or a certified Service Disabled-Veteran Owned Business Enterprise (SDVOBE), certified in accordance with Article 17-B of NYS Executive Law (http://www.ogs.ny.gov/Core/SDVOBA.asp)? Yes (If Yes, identify below) No

( MINORITY-OWNED) ( WOMEN-OWNED) ( MINORITY AND WOMEN-OWNED)

( SMALL BUSINESS: SBE) ( DISADVANTAGED: DBE) ( SERVICE DISABLED: SDVOB)

4(a). If certified SDVOB firm, list DSDVBD CONTROL NO.:

5. Does your company or any individual or legal entity in which your company holds a 10% or greater ownership interest, or any individual or legal entity which holds a 10% or greater ownership interest in your company, have business operations in Northern Ireland? Yes No

6. If you answered yes to question 5, will/do you take lawful steps in good faith to conduct any business operations that you have in

Northern Ireland in accordance with the MacBride Fair Employment Principles relating to nondiscrimination in employment and freedom of workplace opportunity regarding such operations in Northern Ireland, and will you permit independent monitoring of their compliance with such Principles? Yes No (explain/attachment) N/A

7. Do you acknowledge that the terms and conditions of Appendix A (Standard Clauses for All New York State Contracts), which were set forth in the IFB govern any contract that results from this proposal? Yes No (explain/attachment)

8. Do you certify that you will provide prevailing wage rates and supplements and meet all other requirements of NYS Labor Law (if such Prevailing Wage Rates and Supplements were referenced in the Invitation for Bids)?

Yes No (explain/attachment) N/A https://ny.newnycontracts.com/FrontEnd/VendorSearchPublic.asp http://osdbu.dot.gov/DBEProgram/index.cfm http://www.ogs.ny.gov/Core/SDVOBA.asp

Non-Collusive Bidding Certification:

By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his knowledge and belief:

(1) The prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor;

(2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and

(3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting competition.

Sexual Harassment Prevention Certification:

By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing sexual harassment prevention in the workplace and provides annual sexual harassment prevention training to all of its employees. Such policy shall, at a minimum, meet the requirements of section two hundred one-g of the labor law.

Gender-Based Violence In The Workplace Certification:

Pursuant to NYS State Finance Law §139-M, by submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing gender-based violence and the workplace and has provided such policy to all of its employees, directors and board members. Such policy shall, at a minimum, meet the requirements of subdivision 11 of section five hundred seventy-five of the executive law.

SIGN YOUR PROPOSAL

By signing you indicate your express authority to sign on behalf of yourself, your company, or other entity;

certify to the answers furnished above; certify to the above certifications; indicate full knowledge and acceptance of the terms and conditions set forth in the current edition of the General Specifications (PUR 102), the Invitation for Bids, the specifications set forth therein, and any and all appendices attached hereto.

Bid Proposal Validation

_______________________________________________________________________BY:_________________________________________ _ ________________________________ Name of Authorizing Official (Clearly Print Name Above) Signature Date

Official Title (entered in box above)

Telephone (entered in box above)

Email (entered in box above)