T202503107 Diesel Fuel Cost Price Adjustment Form.pdf

This document is a Diesel Fuel Cost Price Adjustment Option form for Contract No. T202503107, which appears to be associated with a state or local government procurement process. The form requires bidders to make a critical election at the time of bid submission: either opt-in or opt-out of a diesel fuel cost price adjustment mechanism (Special Provision 763626). If the bidder fails to submit this form during bid opening, the OPTION-OUT will be automatically selected, meaning no diesel fuel cost adjustments will be permitted for the contract.

The form provides a standardized method for bidders to choose whether they want to participate in a price adjustment mechanism that likely allows for potential diesel fuel cost fluctuations during the contract period. The document includes spaces for the bidder's organizational name, authorized signature, corporate seal, and notarization, indicating this is an official procurement document with legal standing. The form ensures transparency and gives bidders the opportunity to manage potential fuel cost risks by selecting their preferred pricing approach at the outset of the bidding process.