DOGATE30SB PRICE FORM.docx
DOCX document 27 KB Posted
- Solicitation number
- BPM057632
- Issued by
- Maryland
About this file
This is a price form attachment for a small business contract with the Maryland Department of Transportation (MDOT) State Highway Administration (SHA) for sliding entry gate repair and maintenance services at the Cambridge Shop facility. The contract encompasses four service categories: quarterly gate preventative maintenance inspections (12 per year), repair labor at a straight-time hourly rate for technicians performing gate repairs, maintenance, and installation work (estimated 60 hours annually), trip fees or charges for repair calls (6 trips estimated annually), and repair parts and materials priced at manufacturer's suggested retail price (MSRP) with a fixed allocation of $3,000.00 per year.
Bidders must complete the price form in its entirety without alteration, providing per-unit pricing for Items 1 through 3, with Item 4 fixed at $3,000.00 MSRP, to calculate the total bid amount. The contract is designated as a Small Business Reserve or Preference procurement, requiring all bidders to meet small business qualifications under Maryland State Finance and Procurement Article Section 14-501(c) and maintain this status throughout the contract term, with notification required within 30 days of any change in qualification status. SHA is exempt from Maryland Sales and Use Taxes (Exemption Certificate Number 3000256-3) and Federal Excise Taxes (Exemption Number 52-73-0358K), and bidders must not include taxes in their pricing. All estimated quantities are for bid evaluation purposes only and may not represent actual quantities upon contract award.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1 - No Bid_Vendor Feedback Form.pdf | ||
| DOGATE30SB - IFB.docx | DOCX document |
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Text version
PRICE FORM– ATTACHMENT-B
This form and Small Business Contract Affidavit is to be completed in its entirety, is not to be altered in any way and is to contain only the price or prices stipulated on the form.
Bidders Price Form (DOGATE30SB)
| Column A |
| Column B |
| Column C |
| Column D |
| Item |
| Estimated Quantity |
| Vendor’s Bid Per Unit |
| Total Cost ($) |
| Item 1) Quarterly Gate Preventative Maintenance Inspection. |
| 12/EA |
| $__________EA |
| $__________ |
Item 2) Repair Labor (Straight Time) Routine Hourly Rate -per technician for gate repairs, maintenance, installation, etc.
| 60/HR |
| $___________HR |
| $_________ |
| Item 3) Trip Fee/Charge for Repair |
| 6/EA |
| $____________EA |
| $__________ |
| Item 4) Repair Parts& Materials (MSRP) |
| 1/EA |
| Do Not Alter |
| $3,000.00 |
| TOTAL BID AMOUNT (Sum of Column D) |
| $____________ |
For the Contractor:
Company Name & Address
City State Zip
Representing the above Company _______________________________
SIGNATURE
Print Name & Title
SOCIAL SECURITY NO. OR
FEDERAL TAX ID NO. _________________________ DATE: ___________________
Phone number_____________________________ Email____________________________
NOTE:
a) Quantities are estimated and used for bid evaluation only. They may not represent the actual quantities experienced once the contract is awarded.
b) 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 tax in bid prices
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)
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