Diesel Engine Solicitation Response Sheet.pdf

DQ1 2017000671 – Pg. 1 of 2 Solicitation Response Sheet

SOLICITATION RESPONSE SHEET

DOCUMENTED QUOTE #DQ1 2017000671

Diesel School Instructional Equipment BID SUBMISSION DEADLINE: December 19, 2016; 10:00 AM MT

All prices quoted for goods must include shipping and handling charges and be quoted fob delivery to: Attn:

Andrew Singer; Community College of Aurora, Lowry Campus, Diesel School; Bldg. 840; 1060 Alton Way; Denver, CO 80230. Additional charges for packing or any other purpose will not be allowed.

Completion of this form is required and must be submitted in order that the bid be considered responsive. No substitute form will be accepted. An attached quote may be substituted for listing each item separately on this page. Vendor shall furnish unit price for each item quoted, with a total for each item. In case of error in extension, unit price prevails.

Quote must be detailed with cost per unit, shipping, set up and other charges, as applicable, broken out. Must be inclusive of all charges. Additional charges not appearing on the solicitation response will not be allowed.

VENDOR NAME ____________________________________________________

Delivery Date: Goods must be available for shipment, to meet delivery date of no later than April 18, 2017.

Vendor estimated delivery date:

*****Awarded vendor is not to fill order until they have received a signed purchase order*****

The State will authorize payment to the Vendor after receiving satisfactory or delivery of goods and receipt of the Vendor’s invoice(s).

**Acknowledgment of all modifications (please initial): _________________________

ITEM

NO.

DESCRIPTION QUAN. UNIT UNIT PRICE

(U.S. DOLLARS)

TOTAL

AMOUNT

6 Cylinder Intercooler Turbo Diesel Engine Cutaway

1 ea

2.

Variable Geometry Turbo Cutaway

3. Heavy Duty Rear Axle Cutaway w/o Locking Differential

Shipping and Handling

5.

6.

7.

TOTAL

DQ1 2017000671 – Pg. 2 of 2 Solicitation Response Sheet

Comments:

Quote form must be signed by the representative of the vendor who is legally authorized to bind the company. By signature below, vendor certifies its ability to deliver goods by delivery date.

UNSIGNED BIDS WILL NOT BE CONSIDERED

PLEASE WRITE LEGIBLY

THE FOLLOWING MUST BE COMPLETED:

Vendor Name

Vendor Address

Vendor Phone / Fax

E-Mail Address

Printed Name, Title

Signature

Assured Delivery Date

Payment Terms FOB Destination / Net 45

Using the Federal Government definition, does your company qualify as:

A Small Business Yes____ No____ A Woman Owned Business Yes____ No____

A Minority Business Yes____ No____ If Yes, State Ethnicity

A Service Disabled Veteran Owned Small Business (SDVOSB) (If yes, provide certification)

Yes____ No____

Federal ID Number

Are you a member of the ColoradoVSS System Yes____ No____

ColoradoVSS System vendor number

Solicitation response must include Response Sheet, W-9, and SDVOSB (Service-Disabled Veteran Owned Small Business certification (if applicable to vendor),