GJRC Project Manager Documented Quote.doc

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Grand Junction Regional Center Project Manager
Solicitation number
DQ1 IHKA 2017000047 1
Issued by
Denver County, Denver City, Colorado

About this file

This is a Documented Quote (DQ) solicitation issued by the Colorado Department of Human Services for a Project Manager to manage the implementation of Senate Bill 16-178, which requires the relocation of services and closure of the Grand Junction Regional Center campus. The project encompasses two phases: Phase I focuses on stakeholder engagement and development of a comprehensive relocation plan due December 10, 2016, while Phase II involves implementing the approved plan. Phase I responsibilities include overseeing a seven-member Advisory Group process, facilitating Employee Focus Group meetings, and preparing detailed reports and timelines for vacating and selling the campus. Phase II requirements are contingent on one of two alternatives: Alternative A assumes residents relocate to existing off-campus facilities without requiring new construction, while Alternative B requires project management for capital construction of new homes if demand exceeds current capacity. Vendors must submit fixed-price quotes by July 28, 2016 at 2:00 p.m. Mountain Time via email to brenda.mcgee@state.co.us or by mail to the North Central Procurement office. The contract term runs from August 2016 through July 2018, with all work to be completed on or before the July 1, 2018 campus vacation deadline.

All pricing shall be FOB Destination with vendors required to specify any minimums, special charges, or restrictions. Payment terms must be at least 45 calendar days. Vendors should demonstrate experience facilitating complex workgroups with competing interests and must disclose any conflicts of interest with stakeholder groups or prior Department work. Service Disabled Veteran Owned Small Businesses (SDVOSBs) registered with the Center for Veteran Enterprise may receive a 5 percent price preference if proper certification documentation is submitted. The State intends to issue a single vendor award based on the quote most advantageous to the State, with price being the primary consideration followed by experience, delivery capability, and warranties. Award will result in either a Purchase Order or State Contract, with pricing remaining firm throughout the contract term including any option years. Vendors must provide pricing for both Phase II alternatives to be considered responsive, as the specific scope of Phase II work depends on the relocation plan developed during Phase I and resident service location choices.

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COLORADO DEPARTMENT OF HUMAN SERVICES

Grand Junction Regional Center Project Manager

DQ # 2017000047

STATE OF COLORADO

DEPARTMENT OF HUMAN SERVICES

DOCUMENTED QUOTE (DQ) #
2017000047
QUOTE DUE DATE
07/28/2016 2:00 pm Mtn Time

QUOTE SUBMISSION VIA EMAIL

Submissions via email are preferable.

Email: brenda.mcgee@state.co.us Fax: 303-866-5808

QUOTE SUBMISSION VIA MAIL
Department of Human Services

North Central Procurement 1575 Sherman Street, Denver, CO 80203

PROCUREMENT CONTACT

The procurement contact is the primary contact for this DQ. Direct all inquiries to the procurement contact.

Brenda McGee Brenda.mcgee@state.co.us

PROCUREMENT PHONE NUMBER
303-866-2014

SECTION I - ADMINISTRATIVE INFORMATION

Quote Submission - Quotes will be received until the date and time indicated. Late Quotes may be accepted at the discretion of the Procurement Contact.

Pricing - All pricing shall be FOB Destination. Vendors shall specify any minimums, special charges, restrictions, or conditions. The failure of the vendor to note any special conditions or exceptions shall be deemed a waiver of any such condition or exception.

Price Increases – Pricing shall remain firm for the term of the award, including option years, unless otherwise specified.

Quote Acceptability - The State will be the sole judge in determining the acceptability of a quote and in determining the most beneficial quote for the State. Evaluation of quotes will also take into account administrative costs, payment terms, delivery conditions (any restrictions, minimum order quantity or dollar amount), and any exceptions taken to any requirement of the DQ, volumes at individual user sites, and proximity of user sites. Administrative costs include, but are not limited to, time and costs associated with ordering, receiving, stocking and paying invoices.

Evaluation - The choice of vendor for goods and services must be based on which acceptable response is most advantageous to the state, price/cost being the primary consideration. Other factors to be considered include experience, delivery, and warranties (if applicable). The basis for the selection must be documented and will be final and conclusive unless determined to be arbitrary, capricious, or contrary to law.

Service Disabled Veteran Owned Small Businesses (SDVOSBs) - SDVOSBs, who are incorporated or organized in Colorado or maintain a place of business or have an office in Colorado and who are officially registered and verified as a SDVOSB by the Center for Veteran Enterprise within the U.S. Department of Veterans Affairs. (www.vip.vetbiz.gov) , may receive a 5% preference on their bid. This preference applies only to the price, and the SDVOSBs must still meet all other qualifications required in the bid. SDVOSBs claiming this preference shall submit documentation of SDVOSB certification Issued through the U.S. Department of Veterans Affairs in their response to the solicitation. Bid submissions without this documentation will not be given a preference.

Award - The state intends to issue a single vendor award, unless otherwise specified. Awards will be made on the basis of the quote most beneficial to the State.

Term of Award - The period of award made as a result of this DQ is August, 2016 through July, 2018.

Bid Results - After the award is made, bid tabulations or a summary can be made available.

Purchase Order or State Contract – As a result of the award, a Purchase Order or State Contract may be required. The awarded vendor may not perform or deliver goods or services until such time the Purchase Order or Contract is executed.

Terms and Conditions - The State Purchase Order Terms and Conditions and Solicitation Instructions apply to this DQ. If not attached, they can be made available upon request.

Quantity of Goods/Services – At the time of award and/or during the term of the resulting award, the State reserves the right to increase or decrease the quantity of goods/services based on available funding using the rates established in the Purchase Order or State Contract.

Vendor disclosure of services identifies if the vendor or subcontractor will perform the services outside the state of Colorado or United States. If this is the case, provide a brief statement explaining why the vendor believes it is necessary or advantageous to perform the services outside the state of Colorado or United States.

SECTION II – SPECIFICATIONS / STATEMENT OF WORK

Project:

The Colorado Department of Human Services (Department) seeks a project manager to assist the Department in managing implementation of Senate Bill 16-178, which requires the Department to relocate services offered on the Grand Junctional Regional Center campus, vacate and then sell the campus. The estimated timeline for the project is from July 2016 through July 2018, and the scope of the project work is described later in this document.

Background:

The Department operates three Regional Centers across Colorado that provide residential, day programming and other supportive services to adults with intellectual and developmental disabilities. The three centers are located in Wheat Ridge, Pueblo, and Grand Junction, and as of July 11, 2016 and offer residential services under two different types of licensure. The Grand Junction and Wheat Ridge Regional Centers have residences licensed as Intermediate Care Facilities (ICF) and the Grand Junction and Pueblo Regional Centers have homes licensed as Home and Community Based Services providers (HCBS). ICF residential services are the most acute residential services available in Colorado’s continuum of care for adults with intellectual and developmental disabilities. Home and Community Based Services are offered under Colorado’s 1915(c) Medicaid waiver and are considered a community-based alternative to ICF treatment.

The Regional Centers have the following number of licensed and occupied beds:

Number of Homes, Licensed Beds, and Occupied Beds

By Regional Center License Type

As of July, 11 2016

Number of Residences
Number of Licensed Beds
Number of Occupied Beds
Wheat Ridge ICF
19 (1 offline)
142
117
Pueblo HCBS
11 (1 offline)
88
58
Grand Junction ICF (On Campus)
5 (3 offline)
46
27
Grand Junction HCBS (Off Campus)
9 (1 offline)
80
54

Source: Division for Regional Center Operations data.

Senate Bill 16-178, which passed and was made law this legislative session, requires the Colorado Department of Human Services to vacate the Grand Junction Regional Center campus, no later than July 1, 2018 or as soon as all current residents are transitioned to settings that support their well-being and respect their individual choices. The Department is required to list the campus for sale once the 27 residents have been transitioned to new service locations. At this time, it is anticipated that the residents will be given a choice of moving to other existing Regional Center beds, in Grand Junction, Wheat Ridge, or Pueblo, or to choose services provided in the community through a Community Centered Board. Depending on how many of the 27 individuals choose to remain in Grand Junction Regional Center-provided services, part of implementing Senate Bill 16-178 could include the Department having to seek funding to build new homes to accommodate ICF services for some of the 27 individuals.

Specifically, the law requires the Department to consider the following when it vacates the Grand Junction Regional Center campus:

· Emphasize person-centered services that support the well-being and choice of the person receiving services at the campus;

· Involve the meaningful engagement of the parents or guardians of the person receiving services at the campus;

· Foster community integration and involvement;

· Find a solution that is programmatically and fiscally sustainable;

· Preserve the capacity for the services and support provided by the Regional Center in Grand Junction and must not compromise the capacity for the services and support provided at the Regional Centers in Pueblo and Wheat Ridge;

· Ensure that persons receiving services at the Grand Junction Regional Center campus are transitioned to home-like settings that serve no more than eight persons with intellectual and developmental disabilities;

· Relocate day services and support for persons with disabilities and use the opportunity to enhance the quality of day services and support that are offered and increase the quality of the experience that persons with intellectual and developmental disabilities have with such day services and support;

· Ensure the ongoing success and security of the regional Center’s staff members in Grand Junction;

· Ensure that the Regional Center’s administrative offices will be moved to a leased office location that will house both the accounting and support functions that are currently located on the Grand Junction Regional Center Campus;

· Ensure that the Division of Facility Management employees will be included in the relocation of the Office and the workspace.

· Work with the Joint Budget Committee (a Legislative Committee in the Colorado General Assemble) to ensure that the Division of Facility Management’s resources be redirected to meet the needs of the existing Department facilities and operations to the Grand Junction area that are not on the campus.

· Explore options for the future of laundry services currently provided at the Grand Junction Regional Center campus; and

· Give reasonable notices to any current tenants of the Grand Junction Regional Center campus consistent with the terms of the lease that their lease agreements are terminating and will not be extended.

The law also outlines some specific timelines and requirements for the Department, including:

· No later than July 1, 2018, or as soon as each person receiving services on the campus (as of the effective date of the Senate Bill 16-178), is transitioned to non-regional center campus residences, the Department is to vacate and sell the campus.

· If the Department cannot vacate the campus by July 1, 2018, the Department is required to provide quarterly updates in writing to the Joint Budget Committee and Capital Development Committees of the Colorado General Assembly.

· No later than December 10, 2016, submit a plan for the disposition of the Grand Junction Regional Center campus, including a plan to spend the proceeds of the sale, and make any associated capital construction budget requests related to transitioning persons receiving services to residences not located on the Grand Junction Regional Center campus.

· Convene a seven-member Advisory Group to formulate the plan and budget requests required in the December 2016 plan.

The law was developed and sponsored by a number of legislators, including several of whom participated in the Regional Center Task Force. The priority of the Department is to maintain the highest quality of care for residents of the Grand Junction Regional Center Campus. The law was strongly supported by the members of the Legislature, passing with a vote of 12-1 in the Senate and passing unanimously in the House.

The Department has developed 5 of Employee Focus Groups comprised of Grand Junction Regional Center staff as well as Division for Facilities Management staff. The Focus Groups are specialized in 5 different areas, including (1) Administration, (2) Day Program, (3) Facilities, (4) Health Services and (5) Residential Services. The purpose of the groups is to help involve and engage Department employees in the transition process as well as to ensure the transition goes smoothly and all logistics of the move are identified and managed appropriately. These groups will meet throughout the duration of the transition, until the campus is vacated and sold.

The Department is also in the process of selecting members to serve on the seven-member Advisory Group, as required by Senate Bill 16-178. Due to a significant number of parents and guardians expressing interest in being appointed to the Advisory Group, the Department plans require individuals interested in appointment to the Advisory Group to go through an application process in which interested parties provide an application. Applications will reviewed and members appointed through the same process the Department follows for its appointment of members to other statutorily created boards and commissions.

The following is a rough outline of the upcoming steps that will be followed for the Department to implement the requirements of Senate Bill 16-178.

Tentative Outline of Upcoming Steps Needed to Implement Senate Bill 16-178

Step Description
Timeline
Appointment of Seven Member Advisory Board
Application deadline is 6/27/16
Kick off Advisory Board Meetings, Establish Goals, Timelines, Required Plan Products, and Meeting Schedule
8/1/2016
Parent and Guardian Service Selection. Parents and Guardians can select the type and location of existing services that will best suit the needs of the individual currently served on the campus.
8/1/2016 thru 9/30/2016
Submit a plan for the disposition of the GJRC campus to the Capital Development Committee. This must include a plan to spend the proceeds of the sale and capital construction budget requests for capital construction, capital renewal, or controlled maintenance needs related to transitions
12/10/2016
All waiver beds within the Regional Centers will remain open and an adequate number will be maintained for individuals who transition into the community for the preceding six months. If the transition is deemed unsuccessful by the individual's legal guardian or by the Community Center Board, the department will permit the individual to return to the Regional Center.
Now thru 5/30/2017
If the campus is not vacated by 7/1/2018 quarterly updates in writing will be given to the Joint Budget Committee and Capital Development Committee
6/1/2018
All residents of the GJRC campus will transition into residences developed off site of the existing Grand Junction Regional Center campus.
7/1/2018

Desired Scope of Work:

The Grand Junction campus relocation project scope is split into two phases: (1) Phase I including stakeholder engagement and development of a plan, culminating in a final report, plan for vacating and selling the campus, and budget requests submitted to the Joint Budget Committee and Capital Development Committee in December 2016; and (2) Phase II includes progressing towards one of several potential alternatives for vacating the campus, based on the plan developed by the Department in consultation with the Advisory Group. A fuller description of the scope of work to be included in each Phase, and the potential alternatives for Phase II will follow.

The Department anticipates contracting for Phase I at this time, with the option to amend the contract to incorporate Phase II, and the appropriate alternative to carry out the Plan developed in Phase I.

Phase I:

In Phase I, the Project Manager will be required to:

1. Oversee and facilitate the Advisory Group process to achieve the requirements required by Statute. This includes:

· Ensuring each meeting is properly noticed and facilitated in accordance with Colorado Sunshine Laws (Section 24-6-402, C.R.S.)

· Ensure that the Advisory Group deliberations adhere to SB 16-178 requirements, guidelines and deliverables outlined in the bill, and are focused on the goal of vacating and selling the campus and ensuring person-centered choice of service locations for existing residents.

· Ensure the Advisory Group understands its role is “advisory” only to the Department and that the Department has final decision making authority over content of the recommendations and report.

· Distributing materials to Advisory Board members in Advance via email.

· Maintaining written and audio recording minutes of each meeting, including sign in sheets for all Member, as well as members of the public or meeting attendees (who sign in) as well as a comprehensive and well-organized archive of all materials disseminated, during meetings.

· Allow for 15 minutes of each meeting to be for public comment, document all commentary in written minutes and audio recording of the meeting.

· Provide regular reports to the Department of Human Services regarding Advisory Group activities and recommendations.

· Hold as many Advisory Group meetings as needed to accomplish the requirements of SB 16-178 and to develop a plan for vacating the Grand Junction campus, prepare any associated budget requests, and develop a report to the Joint Budget Committee and Capital Development Committees by no later than December 10, 2016. Meetings should begin August 1, 2016, and may require two or more meetings month from August 1st through November 30th. Schedule and conduct all advisory group meetings in Grand Junction Colorado. Additional meetings may be scheduled as needed in consultation with the Department. Prepare written minutes, project work plan tracking reports and action items identified for every meeting.

· Provide materials to the Department and Advisory Group members in a variety of formats (email, as well as hard copy), and make copies of documents available for members of public who participate in the meetings.

2. Facilitate and document meeting minutes and action items from Employee Focus Group meetings. Employee focus groups will meet once per month between August and December, and then a schedule for meetings during the relocation process will be established based on the report and plan developed and submitted in December. Phase II will include additional requirements for the Project Manager to ensure the Employee Focus Groups are carrying out the actions needed to meet timelines for moving all services, administrative, and individuals off campus to new locations.

3. By October 15, 2016, prepare a draft report for presentation to the Department that includes:

· A summary of the processes and deliberations of the Advisory Group

· Recommendations of the Advisory Group these recommendations shall be presented to the Department’s Executive Management team for input and feedback prior to finalization of the recommendations. Executive Management team feedback and input, if largely different from Advisory Group recommendations shall be taken back to the Advisory Group for further discussion. In all cases, the Advisory Group is serving in an advisory role only and the Department retains final decision making authority over all aspects of the project.

· A plan, including timeline, for vacating the Grand Junction campus and selling it.

4. By November 1, 2016, incorporate feedback from the Department.

5. By November 15, 2016, present draft report to the Advisory Group for final feedback by November 15, 2016.

6. Finalize draft report with any additional feedback from the Advisory Group and provide final bound reports, as well as electronic copies to the Department by December 1, 2016.

Phase II:

In Phase II, the Project Manager will be required to manage the plan developed by the Advisory Committee and approved in the final report. Because the plan is unknown at this time and dependent to some extent on the choices of the residents on the location at which they would like to receive their residential services, this proposal includes two alternative scenarios. All potential bidders must provide pricing for each of the alternatives below.

Alternative A: Plan Does Not Require Building New Homes

Under this alternative, the current residents of the Grand Junction Regional Center ICF homes have selected to relocate to service locations either at another location off-campus. Choices could include another Grand Junction Regional Center home HCBS or ICF home (off-campus), a Wheat Ridge Regional Center or Pueblo Regional Center home, or with a residential service provider in the community (not operated by the Department). Under this scenario, the Project Manager would be responsible for working with the Employee Focus Groups and Department management to establish a workplan to identify administrative lease space for both Regional Center and Facilities staff and to move all individuals, services, and administrative functions off of the campus to new locations. Generally, work that will be required will include:

1. Attendance at all Employee Work Group meetings. Employee Work Group meetings will be held on the Grand Junction campus. It is estimated that in Phase II these meetings would occur at least once per month, but possibly twice per month depending on the pace of the relocation project and need to complete specific tasks.

2. Document through keeping of meeting minutes all Employee Work Group meetings and action items.

3. Develop a Work plan to implement the recommendations of the final report developed by the Department in consultation with the Advisory Group. The work plan must include specific action steps, timelines/due dates, and responsibility assigned to specifically named individuals that will achieve the recommendations of the Advisory Work Group. The Work Plan should be comprehensive, covering every aspect of the project needed to vacate the campus and prepare it for sale. Some actions this will include, but are not limited to:

a. Working with the Department’s Office of Administrative Solutions to identify administrative and facilities management work space off-campus and procure a lease for such space.

b. Ensure that Grand Junction Regional Center Program staff establish appropriate processes to ensure for smooth transition of Regional Center residents to their chosen service location.

c. Coordinate with the Department’s Office of Administrative Solutions to ensure appropriate accommodations are in place to manage all moves of furniture, fixtures and equipment that need to move to new residential, administrative, or facilities management locations.

d. Coordinate with the Department’s Office of Administrative Solutions to procure and build storage space at alternative locations to accommodate all storage needed after closure of the warehouse located on the Regional Center Campus. Funds for this space should be included in the funding for implementation of SB 16-178.

e. Coordinate with the Department’s Office of Administrative Solutions to provide notice to all non-Department tenants on the Grand Junction Regional Center campus that the campus is closing and their lease will terminate by a date commensurate with the plan for vacating the campus.

f. Coordinate with the Department’s Office of Administrative Solutions and the Department of Personnel & Administration’s Office of the State Architect to ensure all necessary site plans and surveys are completed to facilitate the sale of the property. Additionally, the Project Manager will be required to ensure that the Department and Office of the State Architect partner with experts to ensure any cultural artifacts on the land are treated in accordance with the law.

4. Provide written updates (can include provision of meeting minutes and updates in the work plan as to progress towards achieving various steps) to management after each meeting. Project Manager is responsible for notifying management of any concerns, delays, or unexpected items that need to be addressed, or of any additional resources or assistance needed to complete the work plan.

5. Provide final report to include all meeting minutes, action plans and description of implementation.

Alternative B: Plan Requires Building New Homes

Under Alternative B, residents currently served at the Grand Junction Regional Center Campus have chosen to receive ICF services, in Grand Junction provided by the Grand Junction Regional Center that exceeds the Regional Center’s capacity to serve the residents within existing facilities. At this time it is estimated that the Regional Center will have capacity to provide ICF services, off-campus to up to 8 residents in a home that is being re-licensed as an ICF. If more than 8 of the 29 individuals choose ICF services provided in the Grand Junction area by the Department, then the Department will need to pursue capital construction budget request to build enough new homes to serve the individuals who choose to receive ICF services in Grand Junction. Should this occur, and the Department receive capital construction funds to build additional homes, the Project Manager will have all aspects of work outlined in Alternative A, plus be responsible for providing project management and coordination services for the capital construction project of building the new homes. The Project Manager during the capital construction project will serve to coordinate with the Office of Administrative Solutions to ensure all aspects of the project are carried out on time and within budget.

Should capital construction funding for new housing be needed, but not funded, likely neither Alternative A nor B of this project will be completed fully and the scope of work will be adjusted accordingly.

In addition to the work in alternative A to move all administrative and facilities management staff and functions to new locations off-campus and move residents to existing locations off campus, the Project Manager will be responsible for completing the following to build new homes to accommodate additional off-campus ICF beds operated by the Department.

1. Coordinate with the Office of Administrative Solutions and the Office of the State Architect (a Division of the Department of Personnel and Administration responsible for assisting State agencies with capital project management) to develop a Work Plan for the construction of new homes needed to accommodate residents choosing ICF services operated by the Department. The primary role of the Project Manager will be to coordinate between the State Departments involved in the project and the design and construction contractors to ensure the construction project is carried out on-time and within budget and meets all specifications. The Construction Work Plan must include, but is not limited to the following:

a. Creation of Facility Program and Operational Plans to support the capital construction project associated with building the new homes. These plans will likely be able to be drafted through contracting with the Office of the State Architect’s Master Planning agency, RNL construction.

b. All aspects of identify land on which to build homes.

c. All aspects of preparing an RFP and selecting a firm to design the homes.

i. Timelines and milestones to ensure design of the homes is completed on time and within budget.

d. All aspects of preparing an RFP to select an entity to construct the homes.

i. Timelines and milestones to ensure construction of the project is completed on time and within budget.

e. Steps to work with the Departments of Public Health and Environment to ensure newly built homes are licensed as ICF so that individuals can move into the homes.

2. Ensure that Grand Junction Regional Center Program staff establish appropriate processes to ensure for smooth transition of Regional Center residents to the new homes.

3. Provide final report and all written documents, to include all meeting minutes, action plans and description of implementation and any other relevant documentation of the process. Report will be provided in Word (.doc or .docx), Excel (.xls or .xlsx), or other editable text format.

Project Administration:

Throughout both Phase I and Phase II, the Project Manager is responsible for the following:

1. Keeping the Department, including both the Office of Administrative Solutions and the Office of Community Access and Independence, informed of all aspect of the project.

2. Keeping a historical archive of all documentation obtained and reviewed during the process and providing such to the Department at the end of the project.

3. Ensuring the project meets all requirements of Senate Bill 16-178.

4. Keeping the Advisory Group and Employee group discussions and meetings focused on the objectives of Senate Bill 16-178; to vacate and sell the Grand Junction Regional Center Campus.

5. Ensuring all meetings of the Advisory Group are properly announced and documented in meeting minutes.

6. Ensuring all aspects of the project are completed on time, in accordance with project plans and budgets.

7. Serve as the primary point of contact between Advisory Group Members, Employee Focus Group members, Department of Human Services, Office of the State Architect, and other key entities/individuals as defined during the project.

8. Commit resources necessary to attend meetings, schedule interviews, draft meeting minutes, work plans and other reports, and other administrative duties as needed.

SECTION III – INFORMATION REQUIRED ON QUOTE

Quote Response Format:

Vendor should provide in its quote documentation and references that demonstrate the entity's experience in facilitating complex workgroups, comprised of stakeholders with competing interests and ideas, to a successful conclusion in which the group reaches consensus as to the direction forward.

Additionally, Vendor should disclose any conflicts of interest concerning the scope of work, including relationships/ or other business interests in any of the named stakeholder groups, other work conducted for the Department, or anything else that could present an actual or apparent conflict of interest. All conflicts of interest will be evaluated by the Department and proposals may be disqualified if the conflict of interest is deemed significant.

1. Completed and Signed Signature Page. (page 12 of this document)

2. Quote Response including a fixed price/not to exceed cost and pricing.

3. Submit an electronic version (with Signature Page) via email to Brenda.mcgee@state.co.us by the submission due date and time, in a MS Word Document.

SIGNATURE PAGE

VENDOR INFORMATION

COMPANY NAME

FEIN

ADDRESS

Name & title of authorized officer & agent:

NAME:

TITLE:

Name & number of contact person for inquiries on your Quote response:

NAME:

NUMBER/EMAIL:

Name & number of contact person for orders if an award to your company is subsequently made:

NAME:

NUMBER/EMAIL:

IMPORTANT: Vendor should read the entire DQ before submitting a Quote. Quotes shall be properly marked with DQ number. All Quotes shall be F.O.B. destination, unless otherwise specified.

PHONE #

Authorized Signature By Officer or Agent of Vendor

FAX #

Date Signed

REMIT ADDRESS:

E-MAIL:

PAYMENT TERMS:

Terms of less than 45 calendar days will not be considered.

SIGNATURE PAGE REQUIRED – RETURN THIS PAGE

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