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Open Enrollment Vendor Assessment Form
Solicitation # OEV23001919 Instructions: Please complete and upload the following form to the attachment section of your bid submission. Upload any additional documentation as required.
· For further information review the Agency Solicitation Specification form under Section C: Proposal Business Information Business Name
| Item No. |
| Description |
| Rate |
| Price |
| 09/01/2022 – 08/30/2023 Labor: Inspection, Maintenance and Hydraulic Repairs: Including Hose Repair and Complete Overhaul of Equipment and Components |
| HOURLY LABOR RATE |
| 09/01/2022 – 08/30/2023 Labor: Overtime Hourly Rate for Inspection, Maintenance and Mechanical Repairs: This rate will involve emergency repairs during storm events and other emergencies |
| OVERTIME HOURLY LABOR RATE |
| 09/01/2022 – 08/30/2023 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
| 4 |
| 09/01/2022 – 08/30/2023 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
| 5 |
| 09/01/2022 – 08/30/2023 Labor- Line Boring: This rate will involve on-site shop time including a maximum of 2 hours travel time |
| HOURLY LABOR RATE |
| 6 |
| 09/01/2022 – 08/30/2023 Hydraulic Oil: Must Meet Applicable Manufacturers Minimum Standards |
| PRICE PER GALLON |
| 7 |
| 09/01/2022 – 08/30/2023 Discount Rate on Non-OEM Parts |
| PERCENT DISCOUNT |
| 8 |
| 09/01/2022 – 08/30/2023 Discount Rate on Unspecified OEM Parts |
| PERCENT DISCOUNT |
| 9 |
| 09/01/2022 – 08/30/2023 Discount Rate on Unspecified Non-OEM Parts |
| PERCENT DISCOUNT |
| 10 |
| 09/01/2023 – 08/30/2024 Labor: Inspection, Maintenance and Hydraulic Repairs: Including Hose Repair and Complete Overhaul of Equipment and Components |
| HOURLY LABOR RATE |
| 11 |
| 09/01/2023 – 08/30/2024 Labor: Overtime Hourly Rate for Inspection, Maintenance and Mechanical Repairs: This rate will involve emergency repairs during storm events and other emergencies |
| OVERTIME HOURLY LABOR RATE |
| 12 |
| 09/01/2023 – 08/30/2024 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
Open Enrollment Vendor Assessment Form
| 13 |
| 09/01/2023 – 08/30/2024 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
| 14 |
| 09/01/2023 – 08/30/2024 Labor- Line Boring: This rate will involve on-site shop time including a maximum of 2 hours travel time |
| HOURLY LABOR RATE |
| 15 |
| 09/01/2023 – 08/30/2024 Hydraulic Oil: Must Meet Applicable Manufacturers Minimum Standards |
| PRICE PER GALLON |
| 16 |
| 09/01/2023 – 08/30/2024 Discount Rate on Non-OEM Parts |
| PERCENT DISCOUNT |
| 17 |
| 09/01/2023 – 08/30/2024 Discount Rate on Unspecified OEM Parts |
| PERCENT DISCOUNT |
| 18 |
| 09/01/2023 – 08/30/2024 Discount Rate on Unspecified Non-OEM Parts |
| PERCENT DISCOUNT |
| 19 |
| 09/01/2024 – 08/30/2025 Labor: Inspection, Maintenance and Hydraulic Repairs: Including Hose Repair and Complete Overhaul of Equipment and Components |
| HOURLY LABOR RATE |
| 20 |
| 09/01/2024 – 08/30/2025 Labor: Overtime Hourly Rate for Inspection, Maintenance and Mechanical Repairs: This rate will involve emergency repairs during storm events and other emergencies |
| OVERTIME HOURLY LABOR RATE |
| 21 |
| 09/01/2024 – 08/30/2025 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
| 22 |
| 09/01/2024 – 08/30/2025 Labor: Road Service Hourly Rate for Maintenance and Mechanical Repairs: This rate will involve on-site repairs including a maximum of 2 hours travel time |
| OVERTIME HOURLY LABOR RATE |
| 23 |
| 09/01/2024 – 08/30/2025 Labor- Line Boring: This rate will involve on-site shop time including a maximum of 2 hours travel time |
| LINE BORING HOURLY LABOR RATE |
| 24 |
| 09/01/2024 – 08/30/2025 Hydraulic Oil: Must Meet Applicable Manufacturers Minimum Standards |
| PRICE PER GALLON |
| 25 |
| 09/01/2024 – 08/30/2025 Discount Rate on Non-OEM Parts |
| PERCENT DISCOUNT |
| 26 |
| 09/01/2024 – 08/30/2025 Discount Rate on Unspecified OEM Parts |
| PERCENT DISCOUNT |
| 27 |
| 09/01/2024 – 08/30/2025 Discount Rate on Unspecified Non-OEM Parts |
| PERCENT DISCOUNT |
Signature
Name
Signature of the Person Submitting this Form
Name of the Person Submitting this Form (print)
Date of Signature
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