ESBD_File_347951_02 (1) Bid Forms.pdf
PDF 402 KB Posted
- Attached to
- Minor Repair Services
- Solicitation number
- ITB24-17839-KM
- Issued by
- Lubbock County, Lubbock City, Texas
About this file
This document is a Bid Form for the City of Lubbock, Texas's Invitation to Bid (ITB) 24-17839-KM for Minor Repair Services. The City is requesting bids for various repair services, including roofing, HVAC, electrical, plumbing, fencing, glass, overhead doors, doors and hardware/locksmith, drain cleaning, parking lot maintenance, backflow testing, drywall and painting, and welding/metal fabrication. The bid form includes estimated quantities, hourly labor rates, and material markup percentages for each service category. Bidders are required to provide information about their company's experience, licenses, service capabilities, and response times. Bids are due by a specific date, and the contract term is not specified.
The pricing terms for this contract include a cost-plus basis for materials, with prior approval required for any equipment rental and associated markup. There is no mention of any set-asides or incumbent contractors. The funding source is not explicitly stated, but it appears to be from the City of Lubbock's budget for these minor repair services.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ESBD_File_347951_01 - ITB 24-17839-KM.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
BID FORM
City of Lubbock, TX
ITB 24-17839-KM
Minor Repair Service
Section I - Roofing Repair
Item Description Est. Number of
Hours
Hourly Rate Total Price
1 Labor – Regular (8-5) 200
2 Labor – After Hours/Holiday 50
3 Labor – Emergency 50
4 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
If no markup is intended, write the word “None” in the space provided. $15,000 x _____ % markup equals $15,000 + __________
Grand Total of Section I – Roofing Services (Items 1-4) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment must be attached to the invoice. Will you comply? Yes ☐ No ☐
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
Department representative. Use Attachment A for approval. Will you comply? Yes ☐ No ☐
Did you meet the requirement to submit a copy of your state license with your bid? Yes ☐ No ☐
How long has your company been in this business? ______________________________________
How many consecutive years of experience do you have in providing these services? ____________
Do you have a local service shop? Yes ☐ No ☐ Adddress:______________________________________________________________________
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
What is your response time to begin a project after receipt of order? __________________________
List any additional information to be considered in evaluating your bid.
Vendor's Signature _____________________ Company's Name ________________________
Section II – HVAC Services
Item Description Est.
Number of
Hours
Hourly
Rate
Total Price
1 Technician/Installer – Regular Hours Regular (8-5) 200
2 Technician –After Hours/Holidays 50
3 Technician – Emergency 50
4 Apprentice– Regular Hours 50
5 Apprentice– After Hour /Holidays
6 Apprentice– Emergency 50
7 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section II – HVAC Services (Items 1-7) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
How long has your company been in this business? ______________________________________
How many consecutive years of experience do you have in providing these services? ____________
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section III – Electrical Services
Hourly
Rate
Total Price
1 Licensed Electrician – Regular Hours (8-5) 200
2 Licensed Electrician – After Hours/Holiday
3 Licensed Electrician – Emergency 50
4 Apprentice – Regular Hours 50
5 Apprentice – After Hours/Holidays
6 Apprentice – Emergency 50
7 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section III- Electrical Services (Items 1-7) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
How long has your company been in this business? ______________________________________
How many consecutive years of experience do you have in providing these services? ____________
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section IV- Plumbing Services
Hourly Rate Total Price
1 Licensed Plumber – Regular Hours (8-5) 200
2 Licensed Plumber – After Hours/Holiday
3 Licensed Plumber – Emergency 50
4 Plumbers – Regular Hours 50
5 Plumbers – After hours/Holidays
6 Plumbers Helper – Emergency 50
7 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section IV Plumber Services (Items 1-7) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment must be attached to the invoice. Will you comply? Yes ☐ No ☐
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section V - Fence Repair
Hourly
Rate
Total Price
1 Labor – Regular (8-5) 200
2 Labor – After Hours/Holiday 50
3 Labor – Emergency 50
4 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section I – Fence Repair Services (Items 1-4) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section VI – Glass Repair
Item Description
Window and Glass Repair Services
Est. Number of Hours
Hourly Rate Total Price
1 Labor – Regular (8-5) 200
2 Labor – After Hours/Holiday 50
3 Labor – Emergency 50
4 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Total Items 1-4 $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. A copy of the receipt for the rental of the equipment must be attached to the invoice.
Will you comply? Yes ☐ No ☐
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section VII – Overhead Door Repair
Hours
Hourly
Rate
Total Price
1 Labor – Regular (8-5) 200
2 Labor – After Hours/Holiday 50
3 Labor – Emergency 50
4 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section VII – Overhead Door Repair Services (Items
1-4)
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section VIII – Doors & Hardware/Locksmith Services
Hours
Hourly
Rate
Total Price
1 Labor – Regular (8-5) 200
2 Labor – After Hours/Holiday 50
3 Labor – Emergency 50
4 Material/Parts – Percentage of markup on estimated $15,000 parts/material based on actual cost to contractor. ______ % Markup.
Grand Total of Section VIII- Doors & Hardware (Items 1-4) $
For reimbursement of rental of equipment, prior approval must be authorized by the City Department representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section IX – Drain Cleaning
1. What is your labor rate per hour for a repair/service call?
(Billed in increments of full, half and ¼ hours)
$ ____________ per hour
2. Is there an associated service fee? If so, what is the service fee charge?
Service Fee $ ____________
3. What is your labor rate per hour for an emergency call?
4. Is there an associated emergency service fee? If so, what is the service fee charge?
5. Is a mileage charge included in the bid price?
If not, what is your mileage fee?
$____________ per mile representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section X – Parking Lot Painting/Cleaning/Repair representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section XI – Backflow Testing (Fire line & Irrigation) representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section XII – Drywall Repair and Painting representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
Section XIII – Welding & Metal Fabrication representative. If applicable: ________ % markup. A copy of the receipt for the rental of the equipment
Materials are to be quoted on a cost-plus basis; percentage of markup to be based on net cost to Contractor, allowing for full credit for trade and/or cash discounts to the, prior approval must be authorized by City
If emergency service is required at night or on weekends, can you respond? Yes ☐ No ☐ What is your response time for an emergency? __________________________________________
What is your response time for calls other than emergency? ________________________________
| Hourly Rate200: |
| Total Price200: |
| Hourly Rate50: |
| Total Price50: |
| Hourly Rate50_2: |
| Total Price50_2: |
| partsmaterial based on actual cost to contractor: |
| undefined: |
| provided 15000 x: |
| markup equals 15000: |
| fill_31: |
| representative If applicable: |
| No: Off |
| undefined_2: Off |
| No_2: Off |
| undefined_3: Off |
| No_3: Off |
| undefined_4: Off |
| How long has your company been in this business: |
| How many consecutive years of experience do you have in providing these services: |
| No_4: Off |
| undefined_5: Off |
| Adddress: |
| No_5: Off |
| undefined_6: Off |
| What is your response time for an emergency: |
| What is your response time for calls other than emergency: |
| What is your response time to begin a project after receipt of order: |
| List any additional information to be considered in evaluating your bid 1: |
| List any additional information to be considered in evaluating your bid 2: |
| List any additional information to be considered in evaluating your bid 3: |
| Companys Name: |
| Hourly Rate200_2: |
| Total Price200_2: |
| Hourly Rate50_3: |
| Total Price50_3: |
| Hourly Rate50_4: |
| Total Price50_4: |
| Hourly Rate50_5: |
| Total Price50_5: |
| Hourly RateApprentice After Hour Holidays: |
| Total PriceApprentice After Hour Holidays: |
| Hourly Rate50_6: |
| Total Price50_6: |
| based on actual cost to contractor: |
| undefined_7: |
| provided 15000 x_2: |
| markup equals 15000_2: |
| fill_45: |
| representative If applicable_2: |
| No_6: Off |
| undefined_8: Off |
| No_7: Off |
| undefined_9: Off |
| No_8: Off |
| undefined_10: Off |
| No_9: Off |
| undefined_11: Off |
| Adddress_2: |
| How long has your company been in this business_2: |
| How many consecutive years of experience do you have in providing these services_2: |
| No_10: Off |
| undefined_12: Off |
| What is your response time for an emergency_2: |
| What is your response time for calls other than emergency_2: |
| What is your response time to begin a project after receipt of order_2: |
| List any additional information to be considered in evaluating your bid 1_2: |
| List any additional information to be considered in evaluating your bid 2_2: |
| List any additional information to be considered in evaluating your bid 3_2: |
| Companys Name_2: |
| Hourly Rate200_3: |
| Total Price200_3: |
| Hourly Rate50_7: |
| Total Price50_7: |
| Hourly Rate50_8: |
| Total Price50_8: |
| Hourly Rate50_9: |
| Total Price50_9: |
| Hourly RateApprentice After HoursHolidays: |
| Total PriceApprentice After HoursHolidays: |
| Hourly Rate50_10: |
| Total Price50_10: |
| based on actual cost to contractor_2: |
| provided 15000 x_3: |
| markup equals 15000_3: |
| 1_4: |
| fill_43: |
| representative If applicable_3: |
| Adddress_3: |
| How long has your company been in this business_3: |
| How many consecutive years of experience do you have in providing these services_3: |
| What is your response time for an emergency_3: |
| What is your response time for calls other than emergency_3: |
| What is your response time to begin a project after receipt of order_3: |
| List any additional information to be considered in evaluating your bid 1_3: |
| List any additional information to be considered in evaluating your bid 2_3: |
| List any additional information to be considered in evaluating your bid 3_3: |
| Companys Name_3: |
| Hourly Rate200_4: |
| Total Price200_4: |
| Hourly Rate50_11: |
| Total Price50_11: |
| Hourly Rate50_12: |
| Total Price50_12: |
| Hourly Rate50_13: |
| Total Price50_13: |
| Hourly RatePlumbers After hoursHolidays: |
| Total PricePlumbers After hoursHolidays: |
| Hourly Rate50_14: |
| Total Price50_14: |
| based on actual cost to contractor_3: |
| undefined_13: |
| provided 15000 x_4: |
| markup equals 15000_4: |
| fill_41: |
| representative If applicable_4: |
| Adddress_4: |
| How long has your company been in this business_4: |
| How many consecutive years of experience do you have in providing these services_4: |
| What is your response time for an emergency_4: |
| What is your response time for calls other than emergency_4: |
| What is your response time to begin a project after receipt of order_4: |
| List any additional information to be considered in evaluating your bid 1_4: |
| List any additional information to be considered in evaluating your bid 2_4: |
| List any additional information to be considered in evaluating your bid 3_4: |
| Companys Name_4: |
| Hourly Rate200_5: |
| Total Price200_5: |
| Hourly Rate50_15: |
| Total Price50_15: |
| Hourly Rate50_16: |
| Total Price50_16: |
| partsmaterial based on actual cost to contractor_2: |
| undefined_14: |
| provided 15000 x_5: |
| markup equals 15000_5: |
| fill_31_2: |
| representative If applicable_5: |
| How long has your company been in this business_5: |
| How many consecutive years of experience do you have in providing these services_5: |
| What is your response time for an emergency_5: |
| What is your response time for calls other than emergency_5: |
| What is your response time to begin a project after receipt of order_5: |
| List any additional information to be considered in evaluating your bid 1_5: |
| List any additional information to be considered in evaluating your bid 2_5: |
| List any additional information to be considered in evaluating your bid 3_5: |
| Companys Name_5: |
| Hourly Rate200_6: |
| Total Price200_6: |
| Hourly Rate50_17: |
| Total Price50_17: |
| Hourly Rate50_18: |
| Total Price50_18: |
| partsmaterial based on actual cost to contractor_3: |
| undefined_18: |
| provided 15000 x_6: |
| markup equals 15000_6: |
| fill_30: |
| How long has your company been in this business_6: |
| How many consecutive years of experience do you have in providing these services_6: |
| What is your response time for an emergency_6: |
| What is your response time for calls other than emergency_6: |
| What is your response time to begin a project after receipt of order_6: |
| List any additional information to be considered in evaluating your bid 1_6: |
| List any additional information to be considered in evaluating your bid 2_6: |
| 1_8: |
| 2_8: |
| 3_7: |
| Companys Name_6: |
| Hourly Rate200_7: |
| Total Price200_7: |
| Hourly Rate50_19: |
| Total Price50_19: |
| Hourly Rate50_20: |
| Total Price50_20: |
| partsmaterial based on actual cost to contractor_4: |
| undefined_21: |
| provided 15000 x_7: |
| markup equals 15000_7: |
| fill_31_3: |
| representative If applicable_6: |
| How long has your company been in this business_7: |
| How many consecutive years of experience do you have in providing these services_7: |
| What is your response time for an emergency_7: |
| What is your response time for calls other than emergency_7: |
| What is your response time to begin a project after receipt of order_7: |
| List any additional information to be considered in evaluating your bid 1_7: |
| List any additional information to be considered in evaluating your bid 2_7: |
| List any additional information to be considered in evaluating your bid 3_6: |
| Companys Name_7: |
| Hourly Rate200_8: |
| Total Price200_8: |
| Hourly Rate50_21: |
| Total Price50_21: |
| Hourly Rate50_22: |
| Total Price50_22: |
| partsmaterial based on actual cost to contractor_5: |
| undefined_25: |
| provided 15000 x_8: |
| markup equals 15000_8: |
| fill_31_4: |
| representative If applicable_7: |
| How long has your company been in this business_8: |
| How many consecutive years of experience do you have in providing these services_8: |
| What is your response time for an emergency_8: |
| What is your response time for calls other than emergency_8: |
| What is your response time to begin a project after receipt of order_8: |
| List any additional information to be considered in evaluating your bid 1_8: |
| List any additional information to be considered in evaluating your bid 2_8: |
| List any additional information to be considered in evaluating your bid 3_7: |
| Companys Name_8: |
| undefined_26: |
| Service Fee: |
| undefined_27: |
| Service Fee_2: |
| undefined_28: |
| representative If applicable_8: |
| How long has your company been in this business_9: |
| How many consecutive years of experience do you have in providing these services_9: |
| Adddress_5: |
| What is your response time for an emergency_9: |
| What is your response time for calls other than emergency_9: |
| What is your response time to begin a project after receipt of order_9: |
| List any additional information to be considered in evaluating your bid 1_9: |
| List any additional information to be considered in evaluating your bid 2_9: |
| List any additional information to be considered in evaluating your bid 3_8: |
| Companys Name_9: |
| undefined_34: |
| Service Fee_3: |
| undefined_35: |
| Service Fee_4: |
| undefined_36: |
| representative If applicable_9: |
| How long has your company been in this business_10: |
| How many consecutive years of experience do you have in providing these services_10: |
| Adddress_6: |
| What is your response time for an emergency_10: |
| What is your response time for calls other than emergency_10: |
| What is your response time to begin a project after receipt of order_10: |
| List any additional information to be considered in evaluating your bid 1_10: |
| List any additional information to be considered in evaluating your bid 2_10: |
| List any additional information to be considered in evaluating your bid 3_9: |
| Companys Name_10: |
| undefined_42: |
| Service Fee_5: |
| undefined_43: |
| Service Fee_6: |
| undefined_44: |
| representative If applicable_10: |
| How long has your company been in this business_11: |
| How many consecutive years of experience do you have in providing these services_11: |
| Adddress_7: |
| What is your response time for an emergency_11: |
| What is your response time for calls other than emergency_11: |
| What is your response time to begin a project after receipt of order_11: |
| List any additional information to be considered in evaluating your bid 1_11: |
| List any additional information to be considered in evaluating your bid 2_11: |
| List any additional information to be considered in evaluating your bid 3_10: |
| Companys Name_11: |
| undefined_50: |
| Service Fee_7: |
| undefined_51: |
| Service Fee_8: |
| undefined_52: |
| representative If applicable_11: |
| How long has your company been in this business_12: |
| How many consecutive years of experience do you have in providing these services_12: |
| Adddress_8: |
| What is your response time for an emergency_12: |
| What is your response time for calls other than emergency_12: |
| What is your response time to begin a project after receipt of order_12: |
| List any additional information to be considered in evaluating your bid 1_12: |
| List any additional information to be considered in evaluating your bid 2_12: |
| List any additional information to be considered in evaluating your bid 3_11: |
| Companys Name_12: |
| undefined_53: |
| Service Fee_9: |
| undefined_54: |
| Service Fee_10: |
| undefined_55: |
| representative If applicable_12: |
| How long has your company been in this business_13: |
| How many consecutive years of experience do you have in providing these services_13: |
| Adddress_9: |
| What is your response time for an emergency_13: |
| What is your response time for calls other than emergency_13: |
| What is your response time to begin a project after receipt of order_13: |
| List any additional information to be considered in evaluating your bid 1_13: |
| List any additional information to be considered in evaluating your bid 2_13: |
| List any additional information to be considered in evaluating your bid 3_12: |
| Companys Name_13: |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box11: Off |
| Check Box12: Off |
| Check Box13: Off |
| Check Box14: Off |
| Check Box15: Off |
| Check Box16: Off |
| Check Box18: Off |
| Check Box19: Off |
| Check Box20: Off |
| Check Box21: Off |
| Check Box23: Off |
| Check Box24: Off |
| Check Box25: Off |
| Check Box26: Off |
| Check Box27: Off |
| Check Box28: Off |
| Check Box29: Off |
| Check Box30: Off |
| Check Box31: Off |
| Check Box32: Off |
| Check Box33: Off |
| Check Box34: Off |
| Check Box35: Off |
| Check Box36: Off |
| Check Box37: Off |
| Check Box38: Off |
| Check Box39: Off |
| Check Box40: Off |
| Check Box41: Off |
| Check Box42: Off |
| Check Box43: Off |
| Check Box44: Off |
| Check Box45: Off |
| Check Box46: Off |
| Check Box47: Off |
| Check Box48: Off |
| Check Box49: Off |
| Check Box50: Off |
| Check Box51: Off |
| Check Box52: Off |
| Check Box53: Off |
| Check Box54: Off |
| Check Box55: Off |
| Check Box56: Off |
| Check Box57: Off |
| Check Box58: Off |
| Check Box59: Off |
| Check Box60: Off |
| Check Box61: Off |
| Check Box62: Off |
| Check Box63: Off |
| Check Box64: Off |
| Check Box65: Off |
| Check Box66: Off |
| Check Box67: Off |
| Check Box68: Off |
| Check Box69: Off |
| Check Box70: Off |
| Check Box71: Off |
| Check Box72: Off |
| Check Box73: Off |
| Check Box74: Off |
| Check Box75: Off |
| Check Box76: Off |
| Check Box77: Off |
| Check Box78: Off |
| Check Box79: Off |
| Check Box80: Off |
| Check Box81: Off |
| Check Box82: Off |
| Check Box83: Off |
| Check Box84: Off |
| Check Box85: Off |
| Check Box86: Off |
| Check Box87: Off |
| Check Box88: Off |
| Check Box89: Off |
| Check Box90: Off |
| Check Box91: Off |
| Check Box92: Off |
| Check Box93: Off |
| Check Box94: Off |
| Check Box95: Off |
| Check Box96: Off |
| Check Box97: Off |
| Check Box98: Off |
| Check Box99: Off |
| Check Box100: Off |
| Check Box101: Off |
| Check Box102: Off |
| Check Box103: Off |
| Check Box104: Off |
| Check Box105: Off |
| Check Box106: Off |
| Check Box107: Off |
| Check Box108: Off |
| Check Box109: Off |
| Check Box110: Off |
| Check Box111: Off |
| Check Box112: Off |
| Check Box113: Off |
| Check Box114: Off |
| Check Box115: Off |
File details come from the government source that posted it. Updated .