DOOHDR30SB PriceForm.docx

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DOOHDR30SB- Overhead Door Repair and Maintenance - MDOT/SHA Cambridge
Solicitation number
BPM057606
Issued by
Maryland

About this file

This is a bidder's price form attachment for Invitation for Bid (IFB) DOOHDR30SB issued by the Maryland Department of Transportation (MDOT) State Highway Administration (SHA) for overhead door repair and maintenance services at the Cambridge Maintenance Shop. The contract requires bidders to provide pricing for five line items: semi-annual preventative maintenance inspections for 33 overhead doors (6 inspections annually), repair call labor at an hourly rate for 80 estimated hours, trip charges for 10 service calls, rental of a maximum 20-foot electric scissor lift for 10 days, and a repair parts and materials allowance set at $5,000 MSRP. Bidders must complete the form in its entirety without alterations and provide only the specified pricing information along with company information, authorized representative signature, and contact details.

This procurement is designated as a Small Business Reserve or Preference contract, requiring all bidders to certify their status as a qualified small business in Maryland under State Finance and Procurement Article § 14-501(c). Bidders must provide their Small Business Qualification Number and the date of most recent qualification, affirming under penalty of perjury that their firm meets the required qualifications as of the bid submission date. Bidders must also agree to notify the Procurement Officer within 30 days if their small business status changes during the contract term, with failure to do so resulting in potential contract termination for default. The total bid amount is the sum of all line item costs in Column D of the price form.

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Text version

CONTRACT BID FORM ATTACHMENT-B

This form is to be completed in its entirety, and is not to be altered in any way and is to contain only the price or prices stipulated on the form.

DOOHDR30SB: BIDDER’S PRICE FORM

Column A
Column B
Column C
Column D
Line Item
Estimated Quantity
Cost Per Unit
($) Total Cost
Line Item 1) Semi-Annual Preventative Maintenance Inspections for all 33 Overhead Doors located at the Cambridge Maintenance Shop (2 inspections per year)
6 Ea
$__________/ Ea
$______________
Line Item 2) Repair Call – Service Technician Hourly Labor Rate for repairs outside of normal preventative maintenance and inspection services
80 Hours
$__________/ Hour
$______________
Line Item 3) Trip charge for repairs
10 Ea
$__________/ Ea
$______________
Line Item 4) Max 20 ft Electric Scissor Lift (for repairs)
10 Days
$__________/Day
$______________
Line Item 5) Repair Parts and Materials Allowance (MSRP)
Do Not Alter
$5,000.00

$_________________ 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.

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: _____________________________________________________________

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