eVA Attachments.pdf

ATTACHMENT ___

NAME OF MANUFACTURER AND SHIPPING POINT

Solicitation #: _____________

Each bidder shall supply in the space below the name and address of the manufacturer of each item offered and the shipping point.

BID LINE(S): _________________________________________________________

ITEM NUMBER(S):

MANUFACTURER:

ADDRESS:

SHIPPING POINT:

BID LINE(S): _________________________________________________________

ITEM NUMBER(S):

MANUFACTURER:

ADDRESS:

SHIPPING POINT:

BID LINE(S): _________________________________________________________

ITEM NUMBER(S):

MANUFACTURER:

ADDRESS:

SHIPPING POINT:

QQ59583

ATTACHMENT ____

NORMAL AND EMERGENCY CONTACTS

Solicitation # ___________

Send Contracts To:

Bidder's Name/Title

Primary Phone Number

Bidder's Mailing Address E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

ATTACHMENT ______

Solicitation #:

SUBCONTRACTOR APPROVAL REQUEST

No portion of the work (including equipment) shall be subcontracted to another firm or individual without prior written consent of Virginia Department of Transportation (herein referred to as VDOT). In the event that the contractor desires to subcontract some part of the work specified herein, the contractor shall furnish VDOT with the names, qualifications, and experience of their proposed subcontractors for agency approval. The primary contractor shall, however, remain fully liable and responsible for the work performed by its subcontractor(s) and shall assure compliance with all requirements of the contract.

List proposed subcontractor(s), including name, address, contact person, and type of work to be performed under this contract below.

FIRM INDIVIDUAL’S

NAME & ADDRESS

CONTACT PERSON AND

PHONE NUMBER

TYPE OF WORK TO BE

PERFORMED

TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE

QUALIFICATIONS / EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR

Please indicate which above proposed subcontractors are certified (with DSBSD) as Small, Women Owned or Minority Businesses.

Certification Number(s):

FOR VDOT USE ONLY:

The proposed subcontractor(s) listed above is/are approved and accepted under the terms and conditions of the contract requirements herein.

Signature of Authorized VDOT Representative Date Telephone Number

ATTACHMENT _____

USE OF RECYCLED MATERIALS

Solicitation # __________

Notwithstanding the prohibition against used, damaged or obsolete items, vendors are encouraged to use secondary or recycled materials in the manufacture of products to the maximum extent practicable without jeopardizing the performance or intended end use of the product unless such use is precluded due to health and welfare or safety requirements or product specifications contained herein. Please provide and submit the following information regarding goods offered or intended for use on this contract below.

A. Do any of the goods offered contain recycled materials? _____Yes _____No.

B. If so, please qualify the recycled material content.

ATTACHMENT ____

PLASTIC MATERIALS RECYCLED CONTENT

Solicitation # ____________

Bidders must identify whether their plastic materials contain recycled materials and, if so, specify the amount of recycled content in such plastic materials.

☐ None of the materials offered contain plastic ☐ None of the plastic materials offered contain recycled materials ☐ Some or all of the plastic materials offered contain recycled materials. Specify the amount of recycled content below.

BID LINE(S): ______________________________________________________________________, if applicable

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________

Type of Material: _________________________________ Amount of Recycled Content: __________________