IFB 157892 Fillable Forms.pdf
PDF 770 KB Posted
- Attached to
- PET Bottles and Caps
- Solicitation number
- 2026
- Issued by
- Franklin County, Roanoke City, Virginia
About this file
This document is an Invitation for Bid (IFB) issued by the Administrative Services Division/Procurement of the Virginia Department of Transportation (VDOT) for Spray Injection Pothole Patching Services, IFB #157892. The IFB requires bidders to provide detailed equipment information, including owned, rented/leased, and purchased equipment, that will be used to perform the services. Bidders must also complete a Small Business Subcontracting Plan identifying any DSBSD-certified small businesses they plan to utilize. The bid due date is not specified. VDOT will require successful bidders to provide additional documentation for any rented/leased or subcontracted equipment, as well as proof of purchase for any equipment to be purchased, prior to the Notice of Intent to Award. The contract term is not provided.
The IFB includes licensing requirements for Class A, B, and C Virginia Contractors, as well as registration with the Virginia State Corporation Commission. Bidders are also required to provide at least 3 references for similar services provided. Pricing terms, funding sources, and any set-aside requirements are not specified in the IFB.
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Other files
| File | Type | Posted |
|---|---|---|
| IFB 157892 Bid Tab | — | |
| IFB 157892.pdf | ||
| NOA for 157892 | — |
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Text version
Administrative Services Division/Procurement
IFB #:
VENDOR QUALIFICATION / EQUIPMENT
INVENTORY CERTIFICATION
All bidders responding to this IFB are required to complete equipment information for each piece of equipment listed in question #4.
Failure to complete this attachment may render the bid non-responsive.
1. Name of Business:
2. Name of Owner or Chief Executive Officer: Telephone Number:
3. How many years has the firm been in the business of performing the services called for in this IFB?
4. All equipment that will require inspection by VDOT prior to Notice of Award is listed below.
• In Column 1 place an “O” beside each piece of owned equipment. Place N/A in any block (YEAR/MAKE/MODEL/CAPACITY/ID#/VIN) that does not apply for owned equipment
• In Column 1 place an “R” beside each piece of equipment that will be rented/leased or sub-contracted
• In Column 1 place a “P” beside each piece of equipment that is to be purchased.
• For rented, subcontracted or purchased equipment no detail (Year/Make/Model/Capacity/ID#VIN) is required at time of bid submission.
• See #5 for rented/leased, sub-contracted or purchased equipment requirements.
“O” “R” “P” DESCRIPTION YEAR MAKE MODEL CAPACITY ID #/VIN
“O” “R” “P” DESCRIPTION YEAR MAKE MODEL CAPACITY ID #/VIN
5. Rented, leased equipment: Prior to Notice of Intent to Award VDOT shall require the bidder to provide a letter from the applicable entity on company letterhead stating the type of equipment with detailed equipment description and availability for the duration of the contract period, for any equipment intended for use to perform services of this IFB. This letter must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive.
Sub-Contracted equipment: Prior to Notice of Intent to Award VDOT shall require the bidder to complete the sub-contracting form identifying the company they intend to use for sub-contracting and listing of the equipment. This form must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive.
Future equipment purchase: Prior to Notice of Intent to Award, VDOT shall require the bidder to provide proof of purchase with detailed equipment description and confirmed delivery date for any equipment intended for use to perform services of this IFB.
This proof of purchase must be provided to the Contract Officer within 2 business days of request or the bidder will be deemed non-responsive. All purchased equipment must be available by date of award.
6. Is any of the equipment listed above currently committed on any other contract (VDOT / non VDOT) contracts? Yes No If yes, identify which equipment (year, make, model, ID/VIN), where the equipment is committed, contract number(s), name the party to the contract and location.
IFB#: ___________
CONTRACTOR/SUBCONTRACTOR LICENSE REQUIREMENT: By my signature on this solicitation, I certify that this firm/individual and subcontractors is properly licensed for providing the goods/services specified. Furthermore, the contractor and subcontractors shall maintain the required license throughout the term of the contract. The contractor or their subcontractor shall immediately notify the contracting agency in writing in the event the license has been revoked.
Contractor Name: _____________________________________
License # _________________ Type ________________
Subcontractor Name: _________________________
License # _________________ Type ________________
CONTRACTOR REGISTRATION: If a contract for construction, removal, repair or improvement of a building or other real property is for $120,000 or more, or if the total value of all such contracts undertaken by bidder within any 12-month period is $750,000 or more, the bidder is required under Title 54.1-1100, Code of Virginia (1950), as amended, to be licensed by the State Board of Contractors a “CLASS A CONTRACTOR.” If such a contract is for $10,000 or more but less than $120,000, or if the total value of all such contracts undertaken by bidder within any 12-month period is $150,000or more, but less than $750,000 or more, the bidder is required to be licensed as a “CLASS B CONTRACTOR.” If such a contract is over $1,000 but less than $10,000, or if the contractor does less than $150,000 in business in a 12-month period, the bidder is required to be licensed as a “CLASS C CONTRACTOR.” The board shall require a master tradesmen license as a condition of licensure for electrical, plumbing and heating, ventilation and air conditioning contractors. The bidder shall place on the outside of the envelope containing the bid and shall place in the bid over his signature whichever of the following notations is appropriate, inserting his contractor license number:
Licensed Class A Virginia Contractor No. _______________Specialty _______________
Licensed Class B Virginia Contractor No. _______________Specialty _______________
Licensed Class C Virginia Contractor No. _______________Specialty _______________
If the bidder shall fail to provide this information with his bid and shall fail to promptly provide said contractor license number to the Commonwealth in writing when requested to do so before or after the opening of bids, he shall be deemed to be in violation of § 54.1-1115 of the Code of Virginia (1950), as amended, and his bid will not be considered.
If a bidder shall fail to obtain the required license prior to submission of his bid, the bid shall not be considered
Contractor/Subcontractor License Requirement
Administrative Services/Procurement
State Corporation Commission Form
Failure to complete and return this attachment may result in your bid being deemed NON-RESPONSIVE.
IFB #:
Virginia State Corporation Commission (SCC) registration information.
The bidder:
is a corporation or other business entity with the following SCC identification number: ____________
-OR-
is not a corporation, limited liability company, limited partnership, registered limited liability partnership, or business trust -OR-is an out-of-state business entity that does not regularly and continuously maintain as part of its ordinary and customary business any employees, agents, offices, facilities, or inventories in Virginia (not counting any employees or agents in Virginia who merely solicit orders that require acceptance outside Virginia before they become contracts, and not counting any incidental presence of the bidder in Virginia that is needed in order to assemble, maintain, and repair goods in accordance with the contracts by which such goods were sold and shipped into Virginia from bidder’s out-of-state location) -OR-is an out-of-state business entity that is including with this bid an opinion of legal counsel which accurately and completely discloses the undersigned bidder’s current contacts with Virginia and describes why those contacts do not constitute the transaction of business in Virginia within the meaning of § 13.1-757 or other similar provisions in Titles
13.1 or 50 of the Code of Virginia.
**NOTE** >> Check the following box if you have not completed any of the foregoing options but currently have pending before the SCC an application for authority to transact business in the Commonwealth of Virginia and wish to be considered for a waiver to allow you to submit the SCC identification number after the due date for bids (the Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver):
Small Business Subcontracting Plan
IFB # ____________
It is the goal of the Commonwealth that over 42% of its purchases be made from small businesses. All potential bidders are required to include this document with their bid response in order to be considered responsive.
Small Business: "Small business (including micro)” means a business which holds a certification as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD) on the due date for bids.
This shall also include DSBSD-certified women- owned and minority-owned businesses and businesses with DSBSD service disabled veteran owned status when they also hold a DSBSD certification as a small business on the bid due date. Currently, DSBSD offers small business certification and micro business designation to firms that qualify.
Certification applications are available through DSBSD online at www.SBSD.virginia.gov (Customer Service).
Bidder Name:
Preparer Name: Date:
Who will be doing the work: □ I plan to use subcontractors □ I plan to complete all work
Instructions A. If you are certified by the DSBSD as a micro/small business, complete only Section A of this form.
B. If you are not a DSBSD-certified small business, complete Section B of this form. For the bid to be considered and the bidder to be declared responsive, the bidder shall identify the portions of the contract that will be subcontracted to DSBSD-certified small business for the initial contract period in relation to the bidder’s total price for the initial contract period in Section B.
Section A If your firm is certified by the DSBSD provide your certification number and the date of certification.
Certification number: Certification Date:
Section B If the “I plan to use subcontractors box is checked,” populate the requested information below, per subcontractor to show your firm's plans for utilization of DSBSD-certified small businesses in the performance of this contract for the initial contract period in relation to the bidder’s total price for the initial contract period. Certified small businesses include but are not limited to DSBSD-certified women-owned and minority-owned businesses and businesses with DSBSD service disabled veteran-owned status that have also received the DSBSD small business certification. Include plans to utilize small businesses as part of joint ventures, partnerships, subcontractors, suppliers, etc. It is important to note that these proposed participation will be incorporated into the subsequent contract and will be a requirement of the contract. Failure to obtain the proposed participation percentages may result in breach of the contract.
SBSP-IFB PIM-40
B. Plans for Utilization of DSBSD-Certified Small Businesses for this Procurement
Subcontract #1
Company Name: SBSD Cert #:
Contact Name: SBSD Certification:
Contact Phone: Contact Email:
Value % (Initial Term): Contact Address:
Description of Work:
Subcontract #2
Company Name: SBSD Cert #:
Contact Name: SBSD Certification:
Contact Phone: Contact Email:
Value % (Initial Term): Contact Address:
Description of Work:
Subcontract #3
Company Name: SBSD Cert #:
Contact Name: SBSD Certification:
Contact Phone: Contact Email:
Value % (Initial Term): Contact Address:
Description of Work:
Subcontract #4
Company Name: SBSD Cert #:
Contact Name: SBSD Certification:
Contact Phone: Contact Email:
Value % (Initial Term): Contact Address:
Description of Work:
Subcontract #5
Company Name: SBSD Cert #:
Contact Name: SBSD Certification:
Contact Phone: Contact Email:
Value % (Initial Term): Contact Address:
Description of Work:
District or Division
IFB Title: Spray Injection Pothole Patching Services
IFB #157892
NORMAL AND EMERGENCY CONTACTS
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
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
REFERENCES
Bidders should provide a list of at least 3 references where similar goods and/or services have been provided. Each reference shall include the name of the organization, the complete mailing address, the name of the contact person, the email, and the telephone/fax number.
FIRM’S NAME AND ADDRESS CONTACT PERSON EMAIL ADDRESS TELEPHONE / FAX #
| ATTACHMENT _______ |
| IFB #: |
| VENDOR QUALIFICATION / EQUIPMENT INVENTORY CERTIFICATION |
| In Column 1 place an “R” beside each piece of equipment that will be rented/leased or sub-contracted |
| ATTACHMENT Vendor Qualification - Equipment Certification.pdf |
| ATTACHMENT |
| IFB #: |
| In Column 1 place an “R” beside each piece of equipment that will be rented/leased or sub-contracted |
| IFB: 157892 |
| NAME ADDRESS 1: |
| NAME ADDRESS 2: |
| NAME ADDRESS 3: |
| NAME ADDRESS 4: |
| PHONE NUMBER 1: |
| PHONE NUMBER 2: |
| PHONE NUMBER 3: |
| PHONE NUMBER 4: |
| PERFORMED 1: |
| PERFORMED 2: |
| PERFORMED 3: |
| PERFORMED 4: |
| TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 1: |
| TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 2: |
| QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 1: |
| QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 2: |
| Certification Numbers 1: |
| Certification Numbers 2: |
| contract requirements herein: |
| The proposed subcontractors listed above isare approved and accepted under the terms and conditions of the: |
| The bidder: |
| is a corporation or other business entity with the following SCC identification number: |
| OR: Off |
| is not a corporation limited liability company limited partnership registered limited liability partnership or: Off |
| is an outofstate business entity that does not regularly and continuously maintain as part of its ordinary and: Off |
| is an outofstate business entity that is including with this bid an opinion of legal counsel which accurately and: Off |
| Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver: Off |
| FIRMS NAME AND ADDRESSRow1: |
| CONTACT PERSONRow1: |
| EMAIL ADDRESSRow1: |
| TELEPHONE FAX Row1: |
| FIRMS NAME AND ADDRESSRow2: |
| CONTACT PERSONRow2: |
| EMAIL ADDRESSRow2: |
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| FIRMS NAME AND ADDRESSRow3: |
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| EMAIL ADDRESSRow3: |
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| Send Contracts To Bidders NameTitle: |
| Primary Phone Number: |
| Bidders Mailing Address: |
| Email Address: |
| Contact Persons Name: |
| Cellular Telephone Number: |
| Telephone Number Normal Work Hours: |
| Telephone Number After Work Hours: |
| Fax Number: |
| Email Address_2: |
| Contact Persons Name_2: |
| Cellular Telephone Number_2: |
| Telephone Number Normal Work Hours_2: |
| Telephone Number After Work Hours_2: |
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| Cellular Telephone Number_3: |
| Telephone Number Normal Work Hours_3: |
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| Fax Number_3: |
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| Contractor Name: |
| License: |
| Type: |
| Subcontractor Name: |
| License_2: |
| Type_2: |
| Licensed Class A Virginia Contractor No: |
| Specialty: |
| Licensed Class B Virginia Contractor No: |
| Specialty_2: |
| Licensed Class C Virginia Contractor No: |
| Specialty_3: |
| ATTACHMENT: |
| Bidder Name: |
| Preparer Name: |
| Date: |
| I plan to use subcontractors: Off |
| I plan to complete all work: Off |
| Certification number: |
| Certification Date: |
| Company Name: |
| SBSD Cert: |
| Contact Name: |
| SBSD Certification: |
| Contact Phone: |
| Contact Email: |
| Value Initial Term: |
| Contact Address: |
| Description of Work: |
| Company Name_2: |
| SBSD Cert_2: |
| Contact Name_2: |
| SBSD Certification_2: |
| Contact Phone_2: |
| Contact Email_2: |
| Value Initial Term_2: |
| Contact Address_2: |
| Description of Work_2: |
| Company Name_3: |
| SBSD Cert_3: |
| Contact Name_3: |
| SBSD Certification_3: |
| Contact Phone_3: |
| Contact Email_3: |
| Value Initial Term_3: |
| Contact Address_3: |
| Description of Work_3: |
| Company Name_4: |
| SBSD Cert_4: |
| Contact Name_4: |
| SBSD Certification_4: |
| Contact Phone_4: |
| Contact Email_4: |
| Value Initial Term_4: |
| Contact Address_4: |
| Description of Work_4: |
| Company Name_5: |
| SBSD Cert_5: |
| Contact Name_5: |
| SBSD Certification_5: |
| Contact Phone_5: |
| Contact Email_5: |
| Value Initial Term_5: |
| Contact Address_5: |
| Description of Work_5: |
| 1 Name of Business: |
| Name of Owner or ChiefExecutive Officer: |
| Telephone Number: |
| How many years has the firm been in the business of performing the services called for in this IFB: |
| O R PRow1: |
| DESCRIPTIONRow1: |
| YEARRow1: |
| MAKERow1: |
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| ID VINRow1: |
| O R PRow2: |
| DESCRIPTIONRow2: Self Contained, Mobile |
| YEARRow2: |
| MAKERow2: |
| MODELRow2: |
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| ID VINRow2: |
| O R PRow3: |
| DESCRIPTIONRow3: Pothole Patching Equipment |
| YEARRow3: |
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| party to the contract and location 1: |
| party to the contract and location 2: |
| party to the contract and location 3: |
| party to the contract and location 4: |
File details come from the government source that posted it. Updated .