cn00035226.pdf

10 291458 140.000 Case

FRUIT, BANANAS, FULL HANDS, 40 LB/CS

Item text

Delivery: 35 cases on Feb 06, 2012 35 cases on Feb 13, 2012 35 cases on Feb 17, 2012 35 cases on Feb 27, 2012

Bananas, Fresh, Cavendish, Full Hands.

Average of 3 Medium Bananas Per Pound.

Stage 4 To Stage 5 Ripeness Upon Delivery. Bananas Are To Be Of Uniform Shape And Color With Smooth, Fairly Blemish-Free Skin; Free Of Bruises, Broken Skin, Decay Spots, Mold And Dull Off-Color Skin. Acceptable Pack Size:

Full Hand Clusters Packed In 40 Pound

Bidder/Contractor's Name, Address and Phone #:

SCI Retreat 1131791 660 State Route 11 Hunlock Creek PA 18621

DELIVERY

DATE:

02/06/2012

Your vendor number with us (if available): __________________

Page: 1 / 13 RFQ - Invitation For Bids

RETURN BID

BY:

BID OPENING DATE

01/18/2012

BID OPENING TIME

1:30 pm

EXPIRATION DATE OF

CONTRACT:

(IF APPLICABLE)

Contact Information:

Buyer: Barbara Swiatek Phone: 570-674-2717 Fax: (570) 675-2765 E-mail: bswiatek@pa.gov

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

Items To Be Delivered To:

RFQ Date: 01/04/2012

REPRINT

Issuing Office:

Swiatek Barbara SCI Dallas 1000 Follies Road Dallas PA 18612-0286

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

Please Return Quotation To:

Swiatek Barbara SCI Dallas 1000 Follies Road Dallas PA 18612-0286

INSTRUCTIONS FOR FILLING OUT THIS FORM

FOR EACH ITEM LISTED, ENTER YOUR BID AMOUNT IN THE UNIT PRICE COLUMN AND TOTAL COLUMN

THEN ENTER THE TOTAL BID AMOUNT AND SIGN THIS DOCUMENT ON THE LAST PAGE

Type of Security furnished if required:

Certified or bank cashier's check Irrevocable letter of credit Certificate of deposit Other as specified by bid Bond - If annual bond:

What is the name of the principal on the bond?

The following are incorporated by reference herein: 1) the documents attached to this RFQ, if any; 2) the documents incorporated by reference in this RFQ, if any; and 3) the bid and contract terms and conditions, stored on the web site address at www.dgs.state.pa.us for this type of RFQ as of the date of the RFQ.

RFQ, as used herein, means Request for Quotations, Invitation for Bids, Invitation to Qualify, or Request for Proposals, as appropriate. The Bidder/Contractor, intending to be legally bound hereby, offers and agrees, if this submission is accepted, to provide the awarded items at the price(s) set forth below at the time(s) and place(s) specified.

Boxes/Cartons.

20 148725 140.000 Case

APPLES,US FANCY,PER CASE

Item text

Delivery: 35 cases on Feb 06, 2012 35 cases on Feb 13, 2012 35 cases on Feb 17, 2012 35 cases on Feb 27, 2012

Apples, Fresh, U.S. Fancy Grade or Better OR Equivalent Quality Top Grade.

Waxed or Wax Free. Only Acceptable Varieties: Braeburn, Cameo, Cortland, Empire, Fuji, Gala, Ginger Gold, Golden Delicious, Honeycrisp, Jazz, Jonagold, Jonathan, McIntosh, Red Delicious.

Apples Are To Be Mature, Crisp, Flavorful And Well-Colored With Clean, Firm Smooth Skins. Free Of Bruises, Broken Skin, Decay Spots, Mold And Internal Browning. Acceptable Pack Size:

Medium Sized, 113 And 125 Count Only, 38 to 45 Pound Cartons/Boxes, Tray or Cell-Packed.

30 291464 140.000 Case

FRUIT,ORANGE,FRS,100-125,MIN100,38-

40#CS

Item text

Delivery: 35 cases on Feb 06, 2012 35 cases on Feb 13, 2012 35 cases on Feb 17, 2012 35 cases on Feb 27, 2012

Oranges, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade.

Only Acceptable Varieties: Navel and

Page: 2 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

FOR EACH ITEM LISTED, ENTER YOUR BID AMOUNT IN THE UNIT PRICE COLUMN AND TOTAL COLUMN

THEN ENTER THE TOTAL BID AMOUNT AND SIGN THIS DOCUMENT ON THE LAST PAGE

Valencia. Oranges To Be Mature, Well-Shaped With Shiny, Smooth, Blemish-Free Fine-Textured Skin And Firm Yet Resilient To Touch; Free From Rough, Pitting, Browning Skin, Flesh Decay, Mold And Spongy Texture. Acceptable Pack Size: Large/Medium Sized 100, 113 or 125 Count Only, 38 to 40 Pound Cartons/Boxes.

40 291469 60.000 Case

FRUIT, PEARS,

FRS,3MED/LB,MIN100,45LB/CS

Item text

Delivery: 15 cases on Feb 06, 2012 15 cases on Feb 13, 2012 15 cases on Feb 17, 2012 15 cases on Feb 27, 2012

Pears, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade. Only Acceptable Varieties: Anjou, Bartlett, Bosc And Red Bartlett. Pears To Be Mature, Slightly Firm, But Yield To Gentle Pressure At The Stem End And Skin Color Consistent With Variety; Free From Shriveling, Bruises, Scuffing, Stem Puncture, Mold And Water-Soaked Appearance. Acceptable Pack Size: Medium Sized 100, 110 and 120 Count Only, 40 to 46 Pound Cartons/Boxes.

50 291564 20.000 Case

VEG, BROCCOLI CROWNS, FRS, 20 LB/CS

Item text

Delivery: 5 cases on Feb 06, 2012 5 cases on Feb 13, 2012 5 cases on Feb 17, 2012 5 cases on Feb 27, 2012

Broccoli Crowns, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top

Page: 3 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

Grade. Broccoli Crowns Are To Be Trimmed Of Stalk, Firm Textured, Fresh-Looking With Bud Clusters That Are Compact, Dark Green And Purple Tinged; Free From Stalk, Softening Of Texture, Open, Flowering, Discolored, Or Water-Soaked Bud Clusters, And Tough, Woody Stems.

Acceptable Pack Size: 20 Pound Boxes/Cartons, Bulk.

60 291568 80.000 Case

VEG, CABBAGE, HEAD, FRS, 50 LB/CS

Item text

Delivery: 20 cases on Feb 06, 2012 20 cases on Feb 13, 2012 20 cases on Feb 17, 2012 20 cases on Feb 27, 2012

Cabbage, Head, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade. Only Acceptable Variety:

Green/Domestic. Cabbage To Be Well-Formed, Even Colored, Hard and Fairly Heavy For Size, With Leaves That Are Fairly Smooth and Very Compact; Free From Yellow, Discolored and Wilted Leaves, Mold/Mildew And Decay.

Acceptable Pack Size: Large/Medium-Large Sized Only, 50 Pound Cartons/Sacks.

70 291573 60.000 Bag

VEG, CARROT, TOPPED, FRS, 50 LB/BAG

Item text

Delivery: 15 cases on Feb 06, 2012 15 cases on Feb 13, 2012 15 cases on Feb 17, 2012 15 cases on Feb 27, 2012

Carrots, Topped, Fresh, Whole, U.S. No.

1 Grade or Better OR Equivalent Quality

Page: 4 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

Top Grade. Carrots To Be Fresh, Well-Shaped, Firm, Smooth Exterior, Vibrant Orange To Red-Orange Color And Closely Trimmed Tops; Free From Mold/Mildew, Decay, Growth Cracks, Splits, Softness, Flabbiness, Wilt And Green Spots. Acceptable Pack Size:

Medium Sized, 7 to 8 Inches Length and 1-1/4 to 2-1/4 Inch Diameter, 50 Pound Poly Sacks.

80 295499 4.000 Case

VEG,CARROT,STICKS,FRS,PREP,4/5LB/CS

Item text

Delivery: 1 cases on Feb 06, 2012 1 cases on Feb 13, 2012 1 cases on Feb 17, 2012 1 cases on Feb 27, 2012

Carrots, Fresh, Sticks. Prepared From Cleaned And Peeled Carrots; Sticks Shall be Fairly Uniform In Shape And Size And Shall Be 3 To 4 Inches Length And ½ To ¾ Inches Wide. Minimum Of 7 Days Shelf Life Upon Delivery; Cartons/Bags To Be Stamped/Labeled With Production Date And/Or Use-By Date. Free From Mold/Mildew, Decay, Softness, Flabbiness And Wilt. Commercially Packaged And Sealed In Poly/Plastic Bags. Acceptable Pack Size: Foodservice Pack; 5 Pound Poly/Plastic Bags, 20 Pound Per Carton/Box.

90 291578 28.000 Case

VEG, CELERY,PASCAL,

FRS,30-36CT,50-60#CS

Item text

Delivery: 7 cases on Feb 06, 2012 7 cases on Feb 13, 2012 7 cases on Feb 17, 2012

Page: 5 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

7 cases on Feb 27, 2012

Celery, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade.

Only Acceptable Variety: Pascal. Celery To Be Light Green In Color, Long Straight Stalks With Rigid Ribs That Snap Crisply When Bent And Leaves That Are Fresh, Well-Colored And Show No Signs Of Wilting; Free From Yellowing, Wilting, Pitting, Cuts, Softness, Flabbiness, Mold/Mildew And Decay.

Acceptable Pack Size: Large/Medium Sized 30 Or 36 Count Only, 50 To 60 Pound Cartons/Boxes.

100 291581 8.000 Case

VEG, CUCUMBERS, FRS, 50-55 LB/CS

Item text

Delivery: 2 cases on Feb 06, 2012 2 cases on Feb 13, 2012 2 cases on Feb 17, 2012 2 cases on Feb 27, 2012

Cucumbers, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade.

Only Acceptable Variety: Green/Slicing.

Waxed Or Wax Free. Cucumbers To Be Mature, Firm, Well-Shaped, Even Dark Green Color And Uniform Size; Free From Shriveling, Yellowing, Softening, Pitting, Water Soaked Spots, Soft Sunken Ends, Loose Seed Cavity, Mold/Mildew And Decay. Acceptable Pack Size:

Medium/Super Select Sized Only, 50 To 55 Pound Cartons/Boxes.

110 291589 100.000 Bag

VEG, ONION, CLEANED, FRS,PREP,25 LB/BAG

Item text

Delivery: 25 cases on Feb 06, 2012 25 cases on Feb 13, 2012

Page: 6 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

25 cases on Feb 17, 2012 25 cases on Feb 27, 2012

Onion, Fresh, Whole Peeled. Prepared From Cleaned Yellow, White Or Red Dry Onions. Minimum Of 7 Days Shelf Life Upon Delivery; Cartons/Bags To Be Stamped/Labeled With Production Date And/Or Use-By Date. Free From Peel, Mold/Mildew, Decay, Softness, Flabbiness And Wilt. Commercially Packaged And Sealed In Poly/Plastic Bags. Acceptable Pack Size: Foodservice Pack; 5 Pound Poly/Plastic Bags, 20 Pound Per Carton/Box

120 294831 40.000 Case

VEG, PEPPER, SWEET, FRS, 30LB/CS

Item text

Delivery: 10 cases on Feb 06, 2012 10 cases on Feb 13, 2012 10 cases on Feb 17, 2012 10 cases on Feb 27, 2012

Peppers, Sweet, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade. Acceptable Varieties: Sweet Bell Green, Orange, Red Or Yellow. Peppers To Be Mature, Fresh, Firm/Crisp, Fresh-Looking And Brightly Colored; Free From Shriveling, Bruising, Dull-Looking Appearance, Pitting, Mold/Mildew And Decay. Acceptable Pack Size:

Medium/Large Sized Only, 30 to 35 Pound Cartons/Boxes.

130 291603 4.000 Case

VEG, RADISH, FRS, 14-1LB/CS

Item text

Delivery: 1 case on Feb 06, 2012

Page: 7 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

1 case on Feb 13, 2012 1 case on Feb 17, 2012 1 case on Feb 27, 2012

Radish, Fresh, Topped, U.S. No. 1 Grade OR Equivalent Quality Top Grade. Only Acceptable Variety: Red Globe. Radishes To Be Fresh, Well-Formed, Fairly Smooth And Firm With Crisp White Flesh; Free From Softening/ Wilting, Pithiness, Spongy Texture, Root Growth, Dryness, Rough Skin, Cuts/External Damage, Mold/Mildew And Decay. Acceptable Pack Size: 1 Pound Plastic Bags, 14 Pound Per Carton/Box.

140 291611 12.000 Case

VEG, TOMATO, BITE SIZE,FRS,12-1 PT/CS

Item text

Delivery: 3 cases on Feb 06, 2012 3 cases on Feb 13, 2012 3 cases on Feb 17, 2012 3 cases on Feb 27, 2012

Tomatoes, Bite-Size, Fresh, U.S. No. 1 Grade OR Equivalent Quality Top Grade.

Acceptable Varieties: Cherry And Grape;

Stage 6/Red Ripeness Upon Delivery.

Tomatoes To Be Ripe, Rich Red Colored, Firm Fleshed And Smooth With Bright Shiny Skins; Free From Blemishes, Growth Cracks, Cuts, Bruising, Uneven Color, Softening, Mold/Mildew And Decay.

Acceptable Pack Size: 12 Clam Shell Pint Containers Per Case/Flat.

150 294834 12.000 Case

VEG, TOMATO, FRS, 72CNT, 25 LB/CS

Item text

Page: 8 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

Delivery: 3 cases on Feb 06, 2012 3 cases on Feb 13, 2012 3 cases on Feb 17, 2012 3 cases on Feb 27, 2012

Tomatoes, Fresh, U.S. No. 1 Grade OR Equivalent Quality Top Grade. Only Acceptable Variety: Round/Globe; Stage 5/Light Red To Stage 6/Red Ripeness Upon Delivery. Tomatoes To Be Ripe, Red Colored, Firm Fleshed And Smooth With Bright Shiny Skins; Free From Blemishes, Growth Cracks, Cuts, Bruising, Uneven Color, Softening, Mold/Mildew And Decay.

Acceptable Pack Size: Medium/Large Sized Only, 25 Pound Containers/Boxes, Bulk.

160 291576 12.000 Case

VEG,CAULIFLOWER,

HEAD,FRS,9-12CT25-30#CS

Item text

Delivery: 3 cases on Feb 06, 2012 3 cases on Feb 13, 2012 3 cases on Feb 17, 2012 3 cases on Feb 27, 2012

Cauliflower, Head, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade. Only Acceptable Variety:

White. Cauliflower To Be Mature, Creamy White With Compact Curds And Bright Green, Fresh, Firmly Attached Jacket Leaves; Free From Grey-Brown Discoloration, Curd Softening, Water-Soaked Appearance, Spotting, Bruising, Yellowing or Wilted Leaves, Mold/Mildew And Decay. Acceptable Pack Size: Trimmed, Film-Wrapped Heads, Large/Medium Sized 9 And 12 Count Only, 25 to 30 Pound Cartons/Boxes.

Page: 9 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

170 291586 48.000 Case

VEG, LETTUCE, HEAD, FRS, 24 CT,

50/LB/CS

Item text

Delivery: 12 cases on Feb 06, 2012 12 cases on Feb 13, 2012 12 cases on Feb 17, 2012 12 cases on Feb 27, 2012

Lettuce, Fresh, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade.

Only Acceptable Variety: Iceberg.

Lettuce Heads To Be Compact, Light Green Color, Crisp Texture, Springy-Firm And Give Slightly To Gentle Pressure; Free From Wilting, Russet Spotting, Bruising/Rapid Deterioration, Decay And Dried Translucent Outer Leaves.

Acceptable Pack Size: Medium/Large Sized 24 Count Only, 50 Pound Cartons/Boxes.

180 291596 240.000 Case

VEG, POTATO, ALL-PUR, FRS, 50LB/CS

Item text

Delivery: 60 cases on Feb 06, 2012 60 cases on Feb 13, 2012 60 cases on Feb 17, 2012 60 cases on Feb 27, 2012

Potatoes, U.S. No. 1 Grade or Better OR Equivalent Quality Top Grade. Only Acceptable Varieties: Round White, Round Red and Russet. Potatoes To Be Mature, Firm, Smooth, Uniformly Sized And Fairly Clean; Free From Shriveling, Sprouting, Page: 10 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

Wrinkled Skins, Soft Dark Spots, Cut Surfaces, Green-Tinged Skin, Chill Injury, Mold/Mildew And Decay.

Acceptable Pack Size: Size A Only, 50 Pound Cartons/Sacks.

190 275812 1,000.000 lb

VEGETABLE,POTATOES,SWEET

Item text

Delivery: 500 lbs on Feb 17, 2012 500 lbs on Feb 27, 2012

Sweet Potatoes, fresh, free from mold or rot, 40 lbs/case

Material PO text

GENERAL REQUIREMENTS FOR ALL ITEMS:

Header text Produce for the month of Feb 2012 Delivery Schedule: Four Deliveries:

Delivery dates:

Feb 06,2012; Feb 13, 2012; Feb 17, 2012, and Feb 27, 2012

VENDOR--PLEASE NOTE--NOT ALL ITEMS WILL

BE DELIVERED EACH DELIVERY DATE. See individual text areas for specific delivery information for each item.

Delivery schedule and amounts may be adjusted at the discretion of the Food Service Manager or his designee.

Amounts may be increased or decreased to meet institutional need.

Page: 11 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

ALL ITEMS TO BE IN STRICT CONFORMANCE

WITH THE PURCHASE PROPOSAL WHICH BECOMES

PART OF THIS ORDER. FAILURE TO ADHERE

TO THE SPECIFICATIONS MAY RESULT IN

REJECTION AND/OR RETURN OF PRODUCT AT

THE VENDOR'S EXPENSE.

"FOR INFORMATION PURPOSES ONLY"

Vendors are requested to answer the following questions:

1. Are you a minority and/or women owned business?

Check the appropriate item: ___YES

____NO

2. If yes, are you registered as a certified minority and/or women owned business in the Commonwealth of Pennsylvania:

Check the appropriate item:

_____YES _____NO

SECURITY CLEARANCE INFORMATION FOR

VENDORS

All vendors or their subcontractors, who utilize regular delivery transportation, will have to submit clearance checks through the original vendor, for all drivers (regardless if delivery is inside or outside of the fence). Common carriers will not be required to render clearance checks, however they are subject to search and escort procedures.

ALL CARRIERS reporting to outside warehouses must secure their vehicle (windows closed and doors locked), sign in at warehouse and wait for further directions from correctional staff.

VENDOR--PLEASE NOTE--PURCHASE ORDERS TO

BE AWARDED FROM THIS BID THAT ARE $5000

OR GREATER ARE SUBJECT TO THE PROVISIONS

OF THE "RIGHT TO KNOW LAW". IF

Page: 12 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

INSTRUCTIONS FOR FILLING OUT THIS FORM

APPLICABLE, BIDDER AGREES TO ABIDE BY

THE PROVISIONS OF ATTACHMENT

#1--CONTRACT PROVISIONS --RIGHT TO KNOW

LAW.

All Purchase Orders awarded from this bid shall be subject to STD 274 Standard Terms and Conditions (SAP). The bid is governed by STD 203 General Conditions and Instructions for RFQ--Invitation to Bid. Both STD 274 and STD 203 are found on the website, www.dgs.state.pa.us under the Procurement Section heading, Procurement Forms.

Reciprocal Limitations Act Requirements Form must be completed and returned with any bid with a value of $10,000 or greater.

Return your signed bid and completed Reciprocal Limitations Act Requirement Form to Barbara Swiatek, Purchasing Agent, SCI Dallas, 1000 Follies Road, Dallas, Pa 18612-0286 by 01/18/2012 at

1:30 PM. NO FAX BIDS WILL BE ACCEPTED.

BID RETURN ENVELOPES SHOULD BE SEALED

AND IDENTIFIED WITH THE COLLECTIVE

NUMBER CN00035226.

Page: 13 / 13 RFQ - Invitation For Bids

Collective Number:

CN00035226

SHOW THIS NUMBER ON BID ENVELOPE OR

FAX COVER SHEET

RFQ Date: 01/04/2012

REPRINT

Item Description of Items Quantity UOM Unit Total Line No. Price Item Price

Bidder/Contractor's Signature

SIGN AND PRINT NAME BELOW

AUTHORIZED OFFICER / PARTNER / OWNER (CIRCLE ONE) DATE

ENTER TOTAL BID AMOUNT HERE

ALL PRICES ARE

F.O.B. DESTINATION