Request for Bid DOA-3070

Request for Bid DOA-3070
State of Wisconsin
Wis. Statutes s.16.75
DOA-3070 (R05/2014)
BIDS MUST BE SEALED & ADDRESSED TO:
AGENCY ADDRESS:
REQUEST FOR BID
THIS IS NOT AN ORDER
BIDDER (Name and Address)
Remove from bidder list for this commodity/service. (Return this page only.)
Bid envelope must be sealed and plainly marked in lower corner with due date and Request for Bid #
.
Late bids will be rejected. Bids MUST be date and time stamped by the soliciting purchasing office on or before
the date and time that the bid is due. Bids dated and time stamped in another office will be rejected. Receipt of a
bid by the mail system does not constitute receipt of a bid by the purchasing office. Any bid which is inadvertently
opened as a result of not being properly and clearly marked is subject to rejection. Bids must be submitted
separately, i.e., not included with sample packages or other bids. Bid openings are public unless otherwise
specified. Records will be available for public inspection after issuance of the notice of intent to award or the award
of the contract. Bidder should contact the person named below for an appointment to view the bid record. Bids
shall be firm for acceptance for sixty (60) days from date of bid opening, unless otherwise noted. The attached
terms and conditions apply to any subsequent award.
Bids MUST be in this office no later than
Name (Contact for further information)
Phone
Date
Quote Price and Delivery FOB
Fax bids are accepted
Item
No.
Quantity
and Unit
Fax bids are not accepted
Price
Per Unit
Total
Description
Payment Terms
Delivery Time
We claim minority bidder preference [Wis. Stats. s. 16.75(3m)(b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises.
Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact the Wisconsin Supplier Diversity
Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.
We claim disabled veteran owned business bidder preference [Wis. Stats. s. 16.75(3m)(b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED
Disabled Veteran Owned Businesses. Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact
the Wisconsin Supplier Diversity Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.
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) 266-5462.
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.
Name of Authorized Company Representative (Type or Print)
Title
Signature of Above
Date
Phone
Email:
This form can be made available in alternate formats to individuals with disabilities upon request.
Fax
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