Onsite Equipment Washing - Bidder Response Form.docx

DCR 881 - Onsite Equipment Washing

BIDDER RESPONSE FORM

INITIAL RESPONSES ARE DUE BY:______________

INSTRUCTIONS: This form may be completed electronically by typing directly into the grey boxes or printed and completed by hand. If completed electronically, please print after information has been entered and sign in the appropriate location prior to submitting. Be sure to read each section thoroughly. Responses found to be incomplete may be disqualified/excluded from evaluation.

I. Vendor/Bidder Company Name Please specify the name of your company:

II. Number of Years in Business Please specify the number of years your company has been in business:

III. Ability to Provide Services Please specify which of the goods and services listed below your company is able to provide (to check of a box, double-click on the box, then select “Checked” and click “Okay”):

IV. Level of Service Please indicate below which days of the week your company operates and is able to provide the services listed above in Section III.

V. Geographic Service Areas Please indicate which Massachusetts counties your company is able to provide service.

If your company is not able to service the entire Commonwealth of Massachusetts, please indicate which counties you are able to provide service. A map of Massachusetts counties is provided on the last page of this Bidder Response Form.

VI. Onsite Equipment Washing Rate Please provide your company’s flat charge rate for onsite equipment washing. Each rate represents one mobilization for the number of equipment indicated.

Please use the space below, if needed, to provide any comments regarding the rates listed above.

VII. Round-Trip Travel Charge Please use the space below to indicate your round-trip travel charge per mobilization based on the county indicated. Please see county map on the last page of this Bidder Response Form.

Please use the space below, if needed, to provide any comments regarding the round-trip charges above:

VIII. Bidder Experience/Qualifications and Capacity to Provide Goods & Services Please take a moment to briefly describe your company’s ability/capacity to provide the services outlined in the RFR. Please include any specific capabilities or qualifications that demonstrate your company’s ability to fulfill the types of services sought by DCR in this RFR. Bidders are encouraged to describe any specific project(s) or contract(s) of a comparable nature that you have completed or are currently engaged in.

IX. Account Manager Please indicate the person within your company who shall serve as the Account Manager if your company is awarded a contract:

Account Manager Name

Title

Phone Number

Email Address

X. General Liability Insurance In order to be awarded a contract, all bidders must submit evidence of valid general liability insurance. Such evidence can be in the form of a certificate of coverage provided by the bidder’s insurance carrier.

Does your company have general liability insurance coverage?

|_| YES (please be sure to attach evidence of coverage when submitting your proposal)

|_| NO (failure to provide evidence of general liability insurance coverage is grounds for disqualification)

XI. Signature:

Name of Bidder Company

Mailing Address

City/State

Zip Code

Print Name of Authorized Representative

Title of Authorized Representative

Phone Number

Email Address

Signature of Authorized Representative

Date

**By signing above, the bidder hereby certifies that he/she has reviewed and read the Request for Response (RFR) associated with this procurement and understands that if his/her company is awarded a contract their company shall be obligated to abide by all of the terms, conditions, and specifications outlined within that document.** image1.emf image2.png