D._Price_Quote_Proposal_Sheets_f.pdf

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Attached to
SB Minor B - Humboldt County - Install census equipment upgrades and CMS repairs
Solicitation number
01A6632
Issued by
Humboldt County, Humboldt Hill CDP, California

About this file

This is a Price Quote Proposal Sheet from the California Department of Transportation (Caltrans) for Contract Number 01A6632, a SB Minor B project in Humboldt County. The project involves installing census equipment upgrades, CCTV replacement, and changeable message sign (CMS) repairs on a state highway (EA 01-0P780). The scope of work encompasses 11 line items on a lump-sum basis, including lead compliance planning, portable radar speed feedback sign systems, stationary impact attenuator vehicles, traffic management and control systems, changeable message sign modifications, job site management, water pollution control programs, and maintenance of existing traffic management system elements during construction. Bid submittals must be submitted by email only to arlena.tedder@dot.ca.gov, and any bid exceeding $484,000.00 will be rejected per Public Contract Code 10105(b). Payment bonds and insurance will be required at the time of award if the company is selected as the low bidder.

The approximate magnitude of work is $337,600.00. This contract is restricted to certified Small Businesses under section 2-1.05, with no Department-established DVBE contract goal, though DVBE participation is encouraged. The contractor must possess a valid state contractor's license and provide a Federal ID number or Social Security number along with Department of Industrial Relations registration. The bidder must declare that the proposal is made without collusion and agrees to execute the contract within the required timeframe; failure to do so will result in liability for actual damages or 10% of the bid amount, whichever is less. Contractors currently in default with Caltrans on existing contracts may have their bids rejected as non-responsive.

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION

PRICE QUOTE PROPOSAL FOR UNIT ITEMS

DOT ADM-1509 (REV 02/2025)

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.

PERSONAL INFORMATION NOTICE

Pursuant to the Federal Privacy Act (5 U.S.C, Section 552 et seq.) and the Information Practices Act of 1977 (IPA) (Civil Code Sections 1798 et seq.) declares that the right to privacy is a personal and fundamental right protected by the California and United States Constitutions. Please be advised that this form requests personal information. The term “personal information” means any information that is maintained by an agency that identifies or describes an individual, including, but not limited to, the individual’s name, social security number, physical description, home address, home telephone number, education, financial matters, and medical or employment history. It includes statements made by, or attributed to, the individual. (Civil Code, § 1798.3, subdivision (a).)

Information Collection and Access: California law requires the following information to be provided when collecting information from individuals.

(See, for example, Civil Code, § 1798.17.)

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.

DOT ADM-1509 (REV 02/2025)

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.

Contract Number 01A6632

PROPOSAL TO THE STATE OF CALIFORNIA

DEPARTMENT OF TRANSPORTATION

APPROXIMATE MAGNITUDE OF WORK

$337,600.00

FOR: 01-Men-Var-Var. Install census equipment upgrades, CCTV replacement, and CMS repairs. (EA 01-0P780)

The undersigned, as bidder, declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any other person, firm or corporation; and the bidder has carefully examined the proposed form of contract and the plans therein referred, and proposes and agrees, if this proposal is accepted, that the bidder will contract with the State of California to provide all necessary labor, materials, tools, or equipment to do all of the work specified in the contract, in the time and manner therein prescribed, and that the bidder shall take in full payment therefore the following price:

Item Number

Cost Code

Item Unit of

Measure Estimated Quantity

Unit Price (In Figures)

Item Total (In Figures)

1 070030 1LSLEAD COMPLIANCE PLAN

2 010413 1LSPORTABLE RADAR SPEED FEEDBACK

SIGN SYSTEMS

3 013804 1LS

STATIONARY IMPACT ATTENUATOR

VEHICLE

4 066063 1LS

TRAFFIC MANAGEMENT PLAN - PUBLIC

INFORMATION

5 120100 1LSTRAFFIC CONTROL SYSTEM

6 128652 1LS

PORTABLE CHANGEABLE MESSAGE

SIGN (LS)

7 130100 1LSJOB SITE MANAGEMENT

8 130200 1LSPREPARE WATER POLLUTION

CONTROL PROGRAM

9 870009 1LS

MAINTAINING EXISTING TMS

ELEMENTS DURING CONSTRUCTION

10 872135 1LS

MODIFYING TRAFFIC MONITORING

STATIONS

11 872137 1LSMODIFYING CHANGEABLE MESSAGE

SIGN SYSTEMS

DOT ADM-1509 (REV 02/2025)

Contract Number 01A6632

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 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.

TOTAL

1. If the bidder is awarded the contract and refuses to execute the contract forms presented for signature within the time and manner required, the bidder will be liable to the Department of Transportation for actual damages resulting to Caltrans therefrom or 10% of the amount bid, whichever is less. Should the bidder fail to pay these damages, Caltrans may list the bidder as in default and ineligible to bid future Caltrans projects.

2. The bid of any Contractor who is currently in default with Caltrans on a contract already awarded may be regarded as non-responsive and may be rejected. Default is defined as being within a period of liquidated damages on uncompleted work or under notice to begin or complete a contract where work has not commenced within the time limit set forth in that notice or was suspended without valid cause, or failure to perform the required work in a manner satisfactory to the Engineer.

I agree that by providing my electronic signature for this form, I agree to conduct business transactions by electronic means and that my electronic signature is the legal binding equivalent to my handwritten signature. I hereby agree that my electronic signature represents my execution or authentication of this form, and my intent to be bound by it.

BUSINESS NAME (PRINT OR TYPE) DATE

PRINT NAME OF AUTHORIZED PERSON

BY (MUST BE SIGNED BY AUTHORIZED PERSON) TITLE BUSINESS PHONE

BUSINESS ADDRESS (STREET / P.O. BOX, CITY, STATE) ZIP EMAIL

SMALL BUSINESS

CERTIFICATION NUMBER

STATE CONTRACTOR'S

LICENSE BOARD LICENSE

NUMBER

STATE CONTRACTOR'S

LICENSE BOARD LICENSE

CLASSIFICATION

FED ID NUMBER /

SOCIAL SECURITY NUMBER

DEPARTMENT OF INDUSTRIAL RELATIONS REGISTRATION NUMBER

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