D1CAMR28SB Attachment B - Price Form.docx
DOCX document 33 KB Posted
- Solicitation number
- BPM055038
- Issued by
- Maryland
About this file
This is a price form attachment for a video camera pipe inspection services contract (D1CAMR28SB) issued by the State of Maryland. The document serves as the pricing submission template for vendors responding to this procurement opportunity. The form is designed to capture detailed cost information for the inspection services being solicited, with sections for vendors to itemize their pricing based on the service requirements and specifications outlined in the primary contract documents. Vendors must complete this price form as part of their bid submission, with all pricing information to be entered according to the line items and categories specified in the scope of work and bid instructions.
The price form establishes the standardized format and structure through which all bidders must present their financial proposals for evaluation. This document is essential for ensuring competitive transparency and consistent comparison of pricing proposals across all submitted bids. The specific pricing requirements, payment terms, and any volume-based pricing structures are outlined within the form's line items, allowing the State of Maryland to evaluate cost proposals on a uniform basis. Interested vendors should contact Diane Kutskel at 410-677-4000 for clarification on pricing requirements or other procurement details.
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Text version
PRICE FORM- IFB#D1CAMR28SB
CONTRACT BID FORM
ATTACHMENT–B
PAGE1
This form is to be completed in its entirety, is not to be altered in any way and is to contain only the price or prices stipulated on the form for IFB# D1CAMR28SB
| Column A |
| Column B |
| Column C |
| Column D |
| Item |
| Estimated Quantity |
| Vendor’s Bid |
| Total Cost ($) |
| per Unit |
| (Column B x C) |
| Line item #1- Video Inspection camera and monitoring equipment/ with 1 operator - hourly rate |
| 175 Hours |
| $_ _ _/HR |
| $ _ _ |
| Line Item #2 - Additional Technician labor |
| 50 Hours |
| $_ _ /HR |
| $ _ __ |
| Line Item #3 - Mobilization / Demobilization Per Day |
| 15 Unit Day |
| $__ _ /UD |
| $ _ __ |
| Line item #4 - Additional items, rental costs and materials costs |
| Do not alter - $3,000 estimate |
$3,000.00
TOTAL BID AMOUNT (Sum of Column D)
NOTE:
a) SHA is exempt from Maryland Sales and Use Taxes by Exemption Certificate Number 3000256-3 and from Federal Excise Taxes by Exemption Number 52-73-0358K. Do not include sales tax in bid price.
PRICE FORM- IFB#D1CAMR28SB
CONTRACT BID FORM
ATTACHMENT-B
For the Contractor:
Company Name
Address
City State Zip
Phone _____________________ Fax ______________________Email ____________________
Representing the above Company _______________________________
SIGNATURE
Print Name & Title
SOCIAL SECURITY NO. OR
FEDERAL TAX ID NO. _________________________ DATE: ___________________
Maryland Department of Transportation
SMALL BUSINESS CONTRACT AFFIDAVIT
********** PROVIDING FALSE INFORMATION **********
Anyone providing false information to the State of Maryland in connection with obtaining or attempting to obtain a contract under Small Business Reserve or Preference procurement may be subject to the following:
1. A determination by a Procurement Officer that a bidder/offeror is not responsible;
2. A determination that a contract entered into is void or voidable under § 11-204 of the State Finance and Procurement Article of the Annotated Code of Maryland;
3. Suspension and debarment under Title 16 of the State Finance and Procurement Article;
4. Criminal prosecution for procurement fraud (§ 11-205.1 of the State Finance and Procurement Article), perjury, or other crimes; and
5. Other actions permitted by law.
********** FAILURE TO MEET MINIMUM QUALIFICATIONS **********
Any Bidder or potential bidder failing to meet the qualifications of a "small business" specified in § 14-501(c) of the State Finance and Procurement Article will be ineligible to participate in a procurement designated for a Small Business Reserve under § 14-504 or Small Business Preference under § 14-206 - 207. Any person or company bidding on Small Business Reserve or Preference procurement and not qualifying as a small business under § 14-501(c) will have its bid or offer rejected on the ground that the bidder is not responsible.
I AFFIRM THAT:
| To the best of my knowledge, information, and belief, as of the date of submission of this Bid/Proposal, | ||
| (name of firm) meets the qualifications for certification as a Small Business in Maryland. I further affirm that, if for any reason during the term of the contract | (name of firm) no longer meets the qualifications of certification as a Small Business in Maryland, I will notify the Procurement Officer within 30 days. I agree that a failure to so notify the Procurement Officer of this change in circumstances may result in this contract being terminated for default. |
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.
SMALL BUSINESS QUALIFICATION NUMBER ___________________
Date of Most Recent Qualification__________________________________
DATE:_____________
BY:_____________________________________________________________
Signature (Authorized Representative and Affidavit)
File details come from the government source that posted it. Updated .