D._Price_Quote_Proposal_Sheets.pdf

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION

PRICE QUOTE PROPOSAL FOR UNIT ITEMS

DOT ADM-1509 (REV 02/2025)

State of California Department of Transportation Form Title: Price Quote Proposal for Unit Items Form Number: DOT ADM-1509 (Revised February 2025) Americans with Disabilities Act, ADA, Notice, This document is available in alternate accessible formats. For more information, contact the Forms Management Unit at 279 234 2284, Teletype 711, in writing at Forms Management Unit, 1120 N Street, Mail Station 89, Sacramento, California 95814, or by email at Forms.Management.Unit@dot.ca.gov Americans with Disabilities Act (ADA) Notice: This document is available in alternative accessible formats. For more information, please contact the Forms Management Unit at (279) 234-2284, TTY 711, in writing at Forms Management Unit, 1120 N Street, MS-89, Sacramento, CA 95814, or by email at Forms.Management.Unit@dot.ca.gov.

STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION

PRICE QUOTE PROPOSAL FOR UNIT ITEMS

DOT ADM-1509 (REV 02/2025)

State of California Department of Transportation Form Title: Price Quote Proposal for Unit Items Form Number: DOT ADM-1509 (Revised February 2025) Item Number Cost Code Item Unit of Measure Estimated Quantity Unit Price (In Figures) Item Total (In Figures) Americans with Disabilities Act, ADA, Notice, This document is available in alternate accessible formats. For more information, contact the Forms Management Unit at 279 234 2284, Teletype 711, in writing at Forms Management Unit, 1120 N Street, Mail Station 89, Sacramento, California 95814, or by email at Forms.Management.Unit@dot.ca.gov Americans with Disabilities Act (ADA) Notice: This document is available in alternative accessible formats. For more information, please contact the Forms Management Unit at (279) 234-2284, TTY 711, in writing at Forms Management Unit, 1120 N Street, MS-89, Sacramento, CA 95814, or by email at Forms.Management.Unit@dot.ca.gov.

Agency Name and Division Within the Agency Requesting the Information:

California Department of Transportation, Division of Procurement and Contracts, Office 2 Title of Official Responsible for Information Maintenance:

Support Staff, Protest and Policy at the Division of Procurement and Contracts at (279) 234-2382, or in writing at Office 2, 1727 30th Street, MS 65, Sacramento, CA 95816, or by email at NonIT.Contracts@dot.ca.gov Maintenance of the Information Authorized By:

California Constitution, Article 1, Section 1 Government Code Section 11015.5 Health Insurance Portability and Accountability Act (HIPAA) of 1996 – Privacy Rule Information Practices Act (Civil Code Section 1798 et seq.) Public Records Act (Government Code Section 6250 et seq.) State Administrative Manual (SAM) Section Privacy - 5310 et seq. Statewide Information Management Manual (SIMM) 5310-A and 5310-B National Institute of Standards and Technology (NIST) Special Publication 800-53 Consequences of Not Providing All or Any Part of the Requested Information:

Disclosure of this information is mandatory. Failure to provide information will prevent eligibility in the program and delay or prevent the processing of this form.

Principal Purpose(s) for Which the Information Will Be Used:

The request for personal information is to facilitate processing this form and review eligibility for the program.

Known Disclosures:

The information shall be disclosed to authorized California Department of Transportation employees and the information will remain confidential.

Right of Access to Records:

Individuals have the right to access information provided and may request a correction or deletion of records. Exceptions may include, but are not limited to, investigations and public transparency laws. Personal Information will only be disclosed as permitted by the Information Practices Act, Civil Code, §§ 1798–1798.83, or as otherwise required by law. To request access to, or to request correction or deletion of, information provided in this form you may contact the Official Responsible for Information Maintenance identified above.

PROPOSAL TO THE STATE OF CALIFORNIA

DEPARTMENT OF TRANSPORTATION

Item Number Cost Code Item Unit of Measure Estimated Quantity Unit Price (In Figures) Item Total (In Figures) Forms Management Unit Caltrans ADM-1509: Price Quote Proposal for Unit Items

DPAC

Repair/Replacement of Signal and Lighting Systems in Fresno County at Various locations.