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Exhibit A ( 1 of 2) Quote Submission Form
Company Name:
Contact Name:
Address:
City, State, and Zip Code:
Phone Number:
Email:
Floor Mats
| Item |
| Description |
| Frequency |
| Quantity |
| Unit Price |
| Total |
| 1 |
| 3’x5’ high quality water and dirt absorbing mat for entryways |
| Weekly |
| 1 |
| 2 |
| 4’x6’ high quality water and dirt absorbing mat for entryways |
| Weekly |
| 1 |
| $ |
| $ |
| 3 |
| 3’x10’ high quality water and dirt absorbing mat for entryways |
| Weekly |
| 1 |
| $ |
| $ |
| 4 |
| 3’x5’ traffic mat (high quality, heavy construction, does not track or move, guaranteed to lay flat.) |
| Weekly |
| 1 |
| $ |
| $ |
| 5 |
| 4’x6’ traffic mat (high quality, heavy construction, does not track or move, guaranteed to lay flat.) |
| Weekly |
| 1 |
| $ |
| $ |
| 6 |
| 3’x10’ traffic mat (high quality, heavy construction, does not track or move, guaranteed to lay flat.) |
| Weekly |
| 1 |
| $ |
| $ |
*Note: Please provide typical pricing to add ODVA color logo to any of the floor mats (logo will be provided by ODVA if this option is selected). See sample of logo in the Statement of Work – Pictures Related to the Project Section in the RFQ.
Custodial Supplies and Products
| Item |
| Description |
| Quantity |
| Unit Price |
| Total |
| 3 |
| Bathroom Foam Hand Soap |
| 1 |
| $ |
| $ |
| 6 |
| Toilet Paper Dispenser (touch free motion activated) |
| 1 |
| $ |
| $ |
| 7 |
| Paper Towel Dispenser (touch free motion activated) |
| 1 |
| $ |
| $ |
| 8 |
| Hand Soap Dispenser (touch free motion activated) |
| 1 |
| $ |
| $ |
| 9 |
| Hand Sanitizer Dispenser (touch free motion activated) |
| 1 |
| $ |
| $ |
| 10 |
| Air Freshener Dispenser (touch free motion activated) |
| 1 |
| $ |
| $ |
| 11 |
| Trash Bags – 55 gallon |
| 1 |
| $ |
| $ |
| 12 |
| Trash Bags – 13 gallon |
| 1 |
| $ |
| $ |
| 13 |
| Chemical Station |
| 1 |
| $ |
| $ |
| 14 |
| Batteries for all Dispensers |
| 1 |
| $ |
| $ |
| 15 |
| Toilet Seat Covers |
| 1 |
| $ |
| $ |
| 16 |
| Wet Mop Large Size |
| 1 |
| $ |
| $ |
Exhibit A ( 2 of 2) Quote Submission Form
Custodial Supplies and Products
| Item |
| Description |
| Quantity |
| Unit Price |
| Total |
*Note: If labor costs will be associated with refilling custodial supplies and products, please list the amount of cost in the table below.
Labor Associated with Refills (if applicable) of Custodial Supplies and Products
| Item |
| Description |
| Frequency |
| Quantity |
| Unit Price |
| Total |
| 1 |
| Toilet Paper Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 2 |
| Paper Towels Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 3 |
| Air Freshener Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 4 |
| Urinal Screen Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 5 |
| Hand Sanitizer Refill Bladder |
| Weekly |
| 1 |
| $ |
| $ |
| 6 |
| Bathroom Foam Hand Soap Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 7 |
| Floor Cleaner Refill for Chemical Station |
| Weekly |
| 1 |
| $ |
| $ |
| 8 |
| Glass Cleaner Refill for Chemical Station |
| Weekly |
| 1 |
| $ |
| $ |
| 9 |
| Disinfectant Refill for Chemical Station |
| Weekly |
| 1 |
| $ |
| $ |
| 10 |
| Trash Bags – 55-gallon Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 11 |
| Trash Bags – 13-gallon Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 12 |
| Toilet Seat Covers Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 13 |
| Wet Mop Large Size Refill |
| Weekly |
| 1 |
| $ |
| $ |
| 14 |
| Service Charges |
| Weekly |
| 1 |
| $ |
| $ |
| 15 |
| Special Visits |
| Weekly |
| 1 |
| $ |
| $ |
*Note: Please see more details on the information and descriptions in the Statement of Work, Project Description.
Vendor Signature: By signature below the undersigned certifies that they are authorized to act on the behalf of the quoter and will comply with all aspects of the quote herein.
Signature:
Name / Title:
Date:
All Pricing Must Be Held Firm For 90 Days