Signature Page.docx

BID COVER

Wisconsin Department of Military Affairs REQUEST FOR QUOTATION No.: Q-18063

THIS IS NOT AN ORDER

RETURN TO:

WING-SBF, ATTN: PURCHASING

WI DEPT OF MILITARY AFFAIRS

2400 WRIGHT ST, PO BOX 14587

MADISON WI 53708-0587

Title: Used Antifreeze Recycling Services

Date Issued: 03/13/2018

Buyer Contact: Dana Casey or James Richardson 608-242-3158

BIDDER:

Telephone: 608.242.3366

Email: dmapurchasing@wisconsin.gov

Submit Quote by:

Date:

Time:

2:00 pm CDT

Terms: Net 30

and Unit Description

Grand Total

Unit

Used Antifreeze Recycling Services to establish a contractual agreement with one qualified contractor to perform On-Call pickups of used antifreeze products from DMA Maintenance Shops located around the State of Wisconsin.

Bids may be mailed, faxed, or e-mailed to Dana Casey/James Richardson, DMA Purchasing Agent. See address, fax number, and e-mail address listed above. If e-mailed, ensure that the RFQ Quotation Number and Bid Title are listed in the Subject line.

Grand Total from Attachment D – Bid Price Sheet

Bidder Delivery Time (fill in calendar days after receipt of order, if awarded bid):

· Addendums -This firm herby acknowledges receipt / review of the following addendum(s) (If any) Addendum #_____ Addendum #_____Addendum #_____Addendum #_____

|_| We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work Center Program, State Bureau of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-2605.

Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered in our Bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States. |_| Yes |_| No |_| Unknown

In signing this Bid we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit a Bid; that this Bid has been independently arrived at without collusion with any other Bidder, competitor or potential competitor; that this Bid has not been knowingly disclosed prior to the opening of Bids to any other Bidder or competitor; that the above statement is accurate under penalty of perjury.

We will comply with all terms, conditions and specifications required by the state in this Request for Bid and all terms of our Bid.

Fax:

This form can be made available in accessible formats upon request to qualified individuals with disabilities

REQUEST FOR QUOTATION NO: PAGE 2

REV 02/2014

Description

MINORITY BUSINESS ENTERPRISE

Are you a certified MINORITY BUSINESS ENTERPRISE (MBE)? You MUST BE CERTIFIED by Wisconsin Department of Administration (DOA). If you have questions concerning the certification process, contact DOA, 6th floor, 101 E. Wilson St., PO Box 7970, Madison, WI, 53707-7970, Telephone 608-67-9550, website: https://wisdp.wi.gov/. A 5% preference ‘may’ be granted for the quotation award to a CERTIFIED MBE.

_____ YES _____ NO

DISABLED VETERAN-OWNED BUSINESS

Are you a certified DISABLED VETERAN OWNED BUSINESS (DVB)? You MUST BE CERTIFIED by Wisconsin Department of Administration (DOA). If you have questions concerning the certification process, contact DOA, 6th floor, 101 E. Wilson St., PO Box 7970, Madison, WI 53707-7970, Telephone 608-267-9550, website: https://wisdp.wi.gov/ . A 5% preference ‘may’ be granted for the quotation award to a CERTIFIED DVB.

_____ YES _____ NO

VETERAN-OWNED BUSINESS

Are you a "veteran owned business" as defined by s. 16.75(4)(d) and 16.755 Wis. Stats. means a small business, as defined in paragraph (c), that is certified by the Department of Veterans Affairs as being at least 51% owned by one or more veterans, as defined in s. 45.01(12) Wis. Stats.

_____ YES _____ NO

SMALL BUSINESS

Are you a small business as defined by s. 16.75 (4)(c) Wis. Stats. “small business” means a business which has had less than $1.5 million gross annual sales in the most recent calendar of fiscal year.

_____ YES _____ NO

WORK CENTER

Indicate if responding as a work center certified under s. 16.752 Wis. Stats. employing persons with severe disabilities. When engaged in production of materials, supplies or equipment or the performance of contractual services, not less than seventy-five percent (75%) of the total hours of direct labor are performed by severely handicapped individuals. Questions concerning the certification process should be addressed to the Work Center Program, 6th Floor, 101 E. Wilson St., PO Box 7867, Madison, Wisconsin 53707-7867 (608) 266-5462.

_____ YES _____ NO

SERVICES PERFORMED IN USA

The services provided under this bid are all performed in the United States pursuant to s. 16.705 Wis. Stats.

___ YES ___ NO

AMERICAN MADE

The materials covered in our bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts were manufactured in whole or in substantial part in the United States, as defined in s.16.754, Wis. Stats.

_____ YES _____ NO _____ UNKNOWN

BUILDING SECURITY AWARENESS

Because of building security, access to the WisDMA Purchasing Office is restriced and may cause delay if hand delivering your quotation/bid. Allow ample time for security clearance and contact with WisDMA Purchasing Office.

VENDOR REGISTRATION

The State of Wisconsin maintains a list of vendors who wish to conduct business with State agencies. Registered vendors will receive any bid/proposal estimated cost over $50,000 that occurs in the commodity/service area for which you are registered. There are no fees involved. You are encouraged to register with VendorNet. Go to VendorNet’s website: http://vendornet.state.wi.us or call the VendorNet Information center at 1-800-482-7813 or 608-264-7897.

COMPLETE AND RETURN IN BID SUBMITTAL

image1.png