WOHNDMWS25_-_ATTACHMENT_B-_CONTRACT_PRICE_FORM.docx
DOCX document 19 KB Posted
- Attached to
- WOHNDMWS25 State and local contract opportunity
- Solicitation number
- BPM050891
- Issued by
- Wicomico County, Maryland
About this file
This document is a Contract Price Form for the Maryland Department of Transportation (MDOT) for a Small Business Contract, specifically contract number WOHNDMWS25, related to landscaping and labor services. The contract involves two primary service categories: (1) a hand mowing/litter pickup crew consisting of 4 staff with equipment and fuel, priced at a daily crew rate, with an estimated 35 crew days; and (2) additional general labor services, estimated at 80 hours as needed. The document serves as a bid evaluation form where vendors are required to provide per-unit pricing and total cost calculations.
The contract includes a Small Business Affidavit section emphasizing Maryland's procurement regulations for small businesses, with significant legal consequences for providing false information. Vendors must affirm their qualification as a small business in Maryland, with an obligation to notify the Procurement Officer within 30 days if their small business status changes. The form requires detailed vendor information including company name, address, contact details, and a signature from an authorized representative, along with a Small Business Qualification Number and date of most recent qualification.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| WOHNDMWS25_Statewide_IFB_Template_version_2.docx | DOCX document |
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Text version
CONTRACT PRICE FORM
This form is to be completed in its entirety, is not to be altered in any way and is to contain only the price or prices stipulated on the form.
Contract # WOHNDMWS25 Quantities are for bid evaluation only, and are not meant to establish minimum, maximum or exact quantities.
| Column A |
| Column B |
| Column C |
| Column D |
| Item |
| Estimated Quantity |
| Vendor’s Bid |
| Total Cost ($) |
| Per Unit |
| (Column B x C) |
1. HandMowing/litter pickup Crew (4 staff to include Equipment/fuel/etc) daily rate per crew
| 35 Crew Days |
| $_________/ Crew Day |
| $_________ |
2. Additional General Labor (As needed and if needed)
| 80 Hours |
| $_________/ hours |
| $_________ |
| ` |
| TOTAL (sum of column D) |
For the Contractor:
Company Name & Address
City State Zip
Phone _____________________ Fax ______________________Email _____________________________________
Representing the above Company _______________________________
SIGNATURE
Print Name & Title
SOCIAL SECURITY NO. OR
FEDERAL TAX ID NO. _________________________ DATE: ___________________
Maryland Department of Transportation
SMALL BUSINESS CONTRACT AFFIDAVIT
********** PROVIDING FALSE INFORMATION **********
Anyone providing false information to the State of Maryland in connection with obtaining or attempting to obtain a contract under Small Business Reserve or Preference procurement may be subject to the following:
1. A determination by a Procurement Officer that a bidder/offeror is not responsible;
2. A determination that a contract entered into is void or voidable under § 11-204 of the State Finance and Procurement Article of the Annotated Code of Maryland;
3. Suspension and debarment under Title 16 of the State Finance and Procurement Article;
4. Criminal prosecution for procurement fraud (§ 11-205.1 of the State Finance and Procurement Article), perjury, or other crimes; and
5. Other actions permitted by law.
********** FAILURE TO MEET MINIMUM QUALIFICATIONS **********
Any Bidder or potential bidder failing to meet the qualifications of a "small business" specified in § 14-501(c) of the State Finance and Procurement Article will be ineligible to participate in a procurement designated for a Small Business Reserve under § 14-504 or Small Business Preference under § 14-206 - 207. Any person or company bidding on Small Business Reserve or Preference procurement and not qualifying as a small business under § 14-501(c) will have its bid or offer rejected on the ground that the bidder is not responsible.
I AFFIRM THAT:
| To the best of my knowledge, information, and belief, as of the date of submission of this Bid/Proposal, | ||
| (name of firm) meets the qualifications for certification as a Small Business in Maryland. I further affirm that, if for any reason during the term of the contract | (name of firm) no longer meets the qualifications of certification as a Small Business in Maryland, I will notify the Procurement Officer within 30 days. I agree that a failure to so notify the Procurement Officer of this change in circumstances may result in this contract being terminated for default. |
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.
SMALL BUSINESS QUALIFICATION NUMBER ___________________
Date of Most Recent Qualification__________________________________
DATE:_____________
BY:_____________________________________________________________
Signature (Authorized Representative and Affidavit)
File details come from the government source that posted it. Updated .