State of Wisconsin
Wis. Statutes s.16.75
DOA-3070 (R08/2003)
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
# PO1113. 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 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.
UW-Eau Claire
Purchasing Department
105 Garfield Avenue, S103
Eau Claire, WI 54702-4004
715-836-5171 FAX 715-836-4653
Bids MUST be in this office no later than
BIDDER (Name and Address)
May 2, 2011 2:30 PM
Name (Contact for further information)
Penny Odell
April 18, 2011
Quote Price and Delivery FOB
Destination/Prepaid & Installed
Fax bids are accepted
and Unit
1 each
X Fax bids are not accepted
Per Unit
New 7’ Schimmel Grand Piano, polished ebony, Model
#K213T per attached Special Conditions of Bid and the
Standard Terms & Conditions of Bid. Model requested
must be in current inventory.
Please return the Request for Bid Form, Itemized Bid
Form, Designation of Confidential and Proprietary
Information and Wisconsin’s Cooperative Purchasing
Service forms.
Payment Terms
Delivery Time
We claim minority bidder preference [Wis. Stats. s. 16.75(3m)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must be
certified by the Wisconsin Department of Commerce. If you have questions concerning the certification process, contact the Wisconsin Department of Commerce, 5th Floor, 201 W. Washington
Ave., Madison, Wisconsin 53702, (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) 266-2605.
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
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
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)
Signature of Above
Federal Employer Identification No.
Social Security No. if Sole
Proprietor (Voluntary)
This form can be made available in accessible formats upon request to qualified individuals with disabilities
Special Conditions of Bid
New Schimmel Grand Piano
1. Scope: It is the intent of the University of Wisconsin, Department of Music & Theatre Art to purchase one new
Schimmel grand piano. Piano must include a padded Artist bench and installed Dual Tank Dampp-Chaser humidifier
with undercover and standard piano warranty. An onsite tuning will not be required.
Piano faculty will playtest and approve piano from available inventory before award can be issued and delivery can be
Conditions of bid which include the word “must” or “shall” describe a mandatory requirement. All specifications are
defined as mandatory minimum requirements unless otherwise stated. If no bidder is able to comply with a given
specification, condition of bid or provide a specific product on the Itemized Bid Form, Purchasing reserves the right
to delete that specification, condition of bid or item.
See Specifications and/or Itemized Bid List for the minimum acceptable specifications for equipment desired. Bids
on alternate items will not be accepted.
Failure to meet a mandatory requirement will disqualify your bid.
No revisions to this bid may be made unless in the form of official written addendum issued by the University of
Wisconsin-Eau Claire Purchasing Services office.
Please send two (2) complete sets of your bid.
Retain a copy of your bid response for your file. If a contract is developed from this request for bid, these
documents will become terms and conditions of the contract.
Minority Business Participation: The University of Wisconsin-Eau Claire is committed to the promotion of
minority business in the State’s purchasing program and a goal of placing five (5) percent of its total purchasing
dollars with certified minority businesses. Authority for this program is found in Wisconsin Statutes 15.107(2),
16.75(4), 16.755 and 560.036(2). A listing of certified minority businesses, as well as services and commodities they
provide is available from Department of Commerce, Office of Minority Business Development, 608-267-8379.
Questions regarding certification of minority businesses should be directed to DOA Minority Business Program at
VendorNet: The State of Wisconsin has implemented a registration service on an internet system called VendorNet
to enable vendors to receive notice of all official sealed bids/proposals (over $25,000.00) as solicited by all state
To obtain information on the state’s bidder registration, please visit the VendorNet Website at or call the VendorNet Information Center (1-800-482-7813).
2. F.O.B. Destination Freight Prepaid and Installed: Item is to be delivered, set up and installed at University of
Wisconsin-Eau Claire campus, 105 Garfield Avenue, Hass Fine Arts Building, Room 260, Eau Claire, WI 54702.
Bid prices must include all packing, freight, insurance, set-up, instruction and operation manuals charged. Items must
be set in place in an area designated by university personnel, demonstrated to be in operating condition and approved
by University personnel. All debris must be removed from the University premises and properly disposed of by the
contractor. Upon installation all operating instructions, operating and maintenance manuals, must be furnished to the
University personnel identified on the purchase order. Delivery is to be scheduled with David Crawford at 715-8364219.
Failure to bid FOB Destination Freight Prepaid and Installed in price may disqualify your bid.
3. On Site Service: In carrying out the scope of this contract, the contractor may be required to perform services on
University property. Bidders cost must include all transportation and insurance charged. The contractor is required to
maintain insurance in compliance with “Standard Terms and Conditions 23.0 Insurance”.
4. Delivery: Delivery and installation is desired as soon as possible ARO. Delivery must include moving currently
installed piano from the delivery location to another studio and moving that piano to another desired location in the
5. Parking: University parking is very limited. Each contractor and/or employee shall make its own arrangements
for parking through the Parking and Transportation Office, Schneider Hall 106, 715-836-2002. No additional costs
will be allowed for parking fees or violations.
6. Bidder Qualifications: To be eligible for an award, you must be qualified and able to provide information as
required or your bid may be disqualified.
6.1 Bidder must be an original Schimmel manufacturer, authorized Schimmel distributor, or Schimmel dealer
authorized by manufacturer with trained and certified service staff.
6.2 Bidder must designate a person(s) to provide customer service, for ordering/expediting, return authorizations,
technical instrument service and warranty issues.
6.3 Contractor shall maintain insurance levels as required in Standard Terms and Conditions. A certificate of
insurance must be provided upon award.
The contractor shall add the Board of Regents of the University of Wisconsin System, its officers, employees and
agents as an additional insured under the commercial general, automobile and contractor’s pollution liability
7. Indemnification: Contractor agrees to hold the University harmless from any loss, claim, damage or liability of
any kind involving an employee, officer or agent of the contractor arising out of or in connection with this agreement
except to the extent that it is founded upon or grows out of the acts or omissions of any of the officers, employees or
agents of the University of Wisconsin System while acting within the scope of their employment where protection is
afforded by ss.893.82 and 895.46(1) Wis.Stats.
8. Specifications: See Specifications and/or Itemized Bid List for the minimum acceptable specifications for
equipment desired. Failure to provide product specifications and information for items bid may disqualify your bid.
Specifications may not be revised without an official written amendment issued by Purchasing.
8.1 Subcontracting:
Any contract resulting from this bid shall not be, in whole or in part, subcontracted, assigned, otherwise
transferred to any other contractor without prior written approval by Purchasing.
The contractor shall be directly responsible for any subcontractor’s performance and work quality when used
by the contractor. Subcontractors must abide by all terms and conditions under this contract.
8.2 Employee Identification:
All contractor’s employees, while working on University property should wear a clearly displayed photo
identification badge (provided by the contractor at the contractor’s cost) showing they are employees of the
9. Method of Bid: Bidders shall submit a unit price for each item listed on the itemized bid form.
10. Method of Award: Award shall be made on the basis of the lowest price and judged to be in the best interest of
the University after UW-Eau Claire piano faculty playtests and approves piano from available inventory.
The successful bidder will be notified by letter of intent on the award by the University of Wisconsin-Eau Claire.
11. Payment Terms: Payment will not be made until the equipment is determined to meet all specifications and
has been accepted by the University. Payment terms may be negotiated with the contractor.
12. Delivery Requirements: Delivery is to be scheduled with David Crawford at 715-836-4219.
13. Additional Information: Please contact Penny Odell, 715-836-5171 if you have any questions regarding
this bid. Technical questions regarding this bid should be directed to Dave Crawford, 715-836-4219.
Itemized Bid Form
1 each New 7’ Schimmel Grand Piano, polished ebony, Model #K213T. Pricing to include
Padded Artist Bench, installed dual tank dampp-chaser humidifier with undercover, standard
piano warranty and all delivery charges.
Bidder Information:
Company Name:________________________________________
Customer Service Contact: ___________________________________
Phone: ________________________
Fax: _____________________
University of Wisconsin-Eau Claire
Standard Terms and Conditions
Request for Bid
SPECIFICATIONS: The specifications in this request are the minimum acceptable. When specific manufacturer and model numbers are used, they are
to establish a design, type of construction, quality, functional capability and/or performance level desired. When alternates are bid/proposed, they must
be identified by manufacturer, stock number, and such other information necessary to establish equivalency. The State of Wisconsin shall be the sole
judge of equivalency. Bidders/proposers are cautioned to avoid bidding alternates to the specifications which may result in rejection of their bid/proposal.
DEVIATIONS AND EXCEPTIONS: Deviations and exceptions from original text, terms, conditions, or specifications shall be described fully, on the
bidder's/proposer's letterhead, signed, and attached to the request. In the absence of such statement, the bid/proposal shall be accepted as in strict
compliance with all terms, conditions, and specifications and the bidders/proposers shall be held liable.
QUALITY: Unless otherwise indicated in the request, all material shall be first quality. Items which are used, demonstrators, obsolete, seconds, or
which have been discontinued are unacceptable without prior written approval by the State of Wisconsin.
QUANTITIES: The quantities shown on this request are based on estimated needs. The state reserves the right to increase or decrease quantities to
meet actual needs.
DELIVERY: Deliveries shall be F.O.B. destination freight prepaid and included unless otherwise specified.
PRICING AND DISCOUNT: The State of Wisconsin qualifies for governmental discounts and its educational institutions also qualify for educational
discounts. Unit prices shall reflect these discounts.
Unit prices shown on the bid/proposal or contract shall be the price per unit of sale (e.g., gal., cs., doz., ea.) as stated on the request or contract.
For any given item, the quantity multiplied by the unit price shall establish the extended price, the unit price shall govern in the bid/proposal
evaluation and contract administration.
Prices established in continuing agreements and term contracts may be lowered due to general market conditions, but prices shall not be subject
to increase for ninety (90) calendar days from the date of award. Any increase proposed shall be submitted to the contracting agency thirty (30)
calendar days before the proposed effective date of the price increase, and shall be limited to fully documented cost increases to the contractor
which are demonstrated to be industrywide. The conditions under which price increases may be granted shall be expressed in bid/proposal
documents and contracts or agreements.
In determination of award, discounts for early payment will only be considered when all other conditions are equal and when payment terms allow
at least fifteen (15) days, providing the discount terms are deemed favorable. All payment terms must allow the option of net thirty (30).
UNFAIR SALES ACT: Prices quoted to the State of Wisconsin are not governed by the Unfair Sales Act.
ACCEPTANCE-REJECTION: The State of Wisconsin reserves the right to accept or reject any or all bids/proposals, to waive any technicality in any
bid/proposal submitted, and to accept any part of a bid/proposal as deemed to be in the best interests of the State of Wisconsin.
Bids/proposals MUST be date and time stamped by the soliciting purchasing office on or before the date and time that the bid/proposal is due.
Bids/proposals date and time stamped in another office will be rejected. Receipt of a bid/proposal by the mail system does not constitute receipt of a
bid/proposal by the purchasing office.
METHOD OF AWARD: Award shall be made to the lowest responsible, responsive bidder unless otherwise specified.
ORDERING: Purchase orders or releases via purchasing cards shall be placed directly to the contractor by an authorized agency. No other purchase
orders are authorized.
PAYMENT TERMS AND INVOICING: The State of Wisconsin normally will pay properly submitted vendor invoices within thirty (30) days of receipt
providing goods and/or services have been delivered, installed (if required), and accepted as specified.
Invoices presented for payment must be submitted in accordance with instructions contained on the purchase order including reference to purchase
order number and submittal to the correct address for processing.
A good faith dispute creates an exception to prompt payment.
TAXES: The State of Wisconsin and its agencies are exempt from payment of all federal tax and Wisconsin state and local taxes on its purchases
except Wisconsin excise taxes as described below.
The State of Wisconsin, including all its agencies, is required to pay the Wisconsin excise or occupation tax on its purchase of beer, liquor, wine,
cigarettes, tobacco products, motor vehicle fuel and general aviation fuel. However, it is exempt from payment of Wisconsin sales or use tax on its
purchases. The State of Wisconsin may be subject to other states' taxes on its purchases in that state depending on the laws of that state. Contractors
performing construction activities are required to pay state use tax on the cost of materials.
GUARANTEED DELIVERY: Failure of the contractor to adhere to delivery schedules as specified or to promptly replace rejected materials shall render
the contractor liable for all costs in excess of the contract price when alternate procurement is necessary. Excess costs shall include the administrative
ENTIRE AGREEMENT: These Standard Terms and Conditions shall apply to any contract or order awarded as a result of this request except where
special requirements are stated elsewhere in the request; in such cases, the special requirements shall apply. Further, the written contract and/or order
with referenced parts and attachments shall constitute the entire agreement and no other terms and conditions in any document, acceptance, or
acknowledgment shall be effective or binding unless expressly agreed to in writing by the contracting authority.
APPLICABLE LAW AND COMPLIANCE: This contract shall be governed under the laws of the State of Wisconsin. The contractor shall at all times
comply with and observe all federal and state laws, local laws, ordinances, and regulations which are in effect during the period of this contract and
which in any manner affect the work or its conduct. The State of Wisconsin reserves the right to cancel this contract if the contractor fails to follow the
requirements of s. 77.66, Wis. Stats., and related statutes regarding certification for collection of sales and use tax. The State of Wisconsin also
reserves the right to cancel this contract with any federally debarred contractor or a contractor that is presently identified on the list of parties excluded
from federal procurement and non-procurement contracts.
ANTITRUST ASSIGNMENT: The contractor and the State of Wisconsin recognize that in actual economic practice, overcharges resulting from antitrust
violations are in fact usually borne by the State of Wisconsin (purchaser). Therefore, the contractor hereby assigns to the State of Wisconsin any and
all claims for such overcharges as to goods, materials or services purchased in connection with this contract.
ASSIGNMENT: No right or duty in whole or in part of the contractor under this contract may be assigned or delegated without the prior written consent
of the State of Wisconsin.
WORK CENTER CRITERIA: A work center must be certified under s. 16.752, Wis. Stats., and must ensure that when engaged in the 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.
NONDISCRIMINATION / AFFIRMATIVE ACTION: In connection with the performance of work under this contract, the contractor agrees not to
discriminate against any employee or applicant for employment because of age, race, religion, color, handicap, sex, physical condition, developmental
disability as defined in s. 51.01(5), Wis. Stats., sexual orientation as defined in s. 111.32(13m), Wis. Stats., or national origin. This provision shall
include, but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination;
rates of pay or other forms of compensation; and selection for training, including apprenticeship. Except with respect to sexual orientation, the
contractor further agrees to take affirmative action to ensure equal employment opportunities.
Contracts estimated to be over twenty-five thousand dollars ($25,000) require the submission of a written affirmative action plan by the
contractor. An exemption occurs from this requirement if the contractor has a workforce of less than twenty-five (25) employees. Within fifteen
(15) working days after the contract is awarded, the contractor must submit the plan to the contracting state agency for approval. Instructions on
preparing the plan and technical assistance regarding this clause are available from the contracting state agency.
The contractor agrees to post in conspicuous places, available for employees and applicants for employment, a notice to be provided by the
contracting state agency that sets forth the provisions of the State of Wisconsin's nondiscrimination law.
Failure to comply with the conditions of this clause may result in the contractor's becoming declared an "ineligible" contractor, termination of the
contract, or withholding of payment.
PATENT INFRINGEMENT: The contractor selling to the State of Wisconsin the articles described herein guarantees the articles were manufactured or
produced in accordance with applicable federal labor laws. Further, that the sale or use of the articles described herein will not infringe any United
States patent. The contractor covenants that it will at its own expense defend every suit which shall be brought against the State of Wisconsin (provided
that such contractor is promptly notified of such suit, and all papers therein are delivered to it) for any alleged infringement of any patent by reason of
the sale or use of such articles, and agrees that it will pay all costs, damages, and profits recoverable in any such suit.
SAFETY REQUIREMENTS: All materials, equipment, and supplies provided to the State of Wisconsin must comply fully with all safety requirements as
set forth by the Wisconsin Administrative Code and all applicable OSHA Standards.
WARRANTY: Unless otherwise specifically stated by the bidder/proposer, equipment purchased as a result of this request shall be warranted against
defects by the bidder/proposer for one (1) year from date of receipt. The equipment manufacturer's standard warranty shall apply as a minimum and
must be honored by the contractor.
INSURANCE RESPONSIBILITY: The contractor performing services for the State of Wisconsin shall:
Maintain worker's compensation insurance as required by Wisconsin Statutes, for all employees engaged in the work.
Maintain commercial liability, bodily injury and property damage insurance against any claim(s) which might occur in carrying out this
agreement/contract. Minimum coverage shall be one million dollars ($1,000,000) liability for bodily injury and property damage including products
liability and completed operations. Provide motor vehicle insurance for all owned, non-owned and hired vehicles that are used in carrying out this
contract. Minimum coverage shall be one million dollars ($1,000,000) per occurrence combined single limit for automobile liability and property
The state reserves the right to require higher or lower limits where warranted.
CANCELLATION: The State of Wisconsin reserves the right to cancel any contract in whole or in part without penalty due to nonappropriation of funds
or for failure of the contractor to comply with terms, conditions, and specifications of this contract.
VENDOR TAX DELINQUENCY: Vendors who have a delinquent Wisconsin tax liability may have their payments offset by the State of Wisconsin.
PUBLIC RECORDS ACCESS: It is the intention of the state to maintain an open and public process in the solicitation, submission, review, and
approval of procurement activities.
Bid/proposal openings are public unless otherwise specified. Records may not be available for public inspection prior to issuance of the notice of intent
to award or the award of the contract.
PROPRIETARY INFORMATION: Any restrictions on the use of data contained within a request, must be clearly stated in the bid/proposal itself.
Proprietary information submitted in response to a request will be handled in accordance with applicable State of Wisconsin procurement regulations
and the Wisconsin public records law. Proprietary restrictions normally are not accepted. However, when accepted, it is the vendor's responsibility to
defend the determination in the event of an appeal or litigation.
Data contained in a bid/proposal, all documentation provided therein, and innovations developed as a result of the contracted commodities or
services cannot be copyrighted or patented. All data, documentation, and innovations become the property of the State of Wisconsin.
Any material submitted by the vendor in response to this request that the vendor considers confidential and proprietary information and which
qualifies as a trade secret, as provided in s. 19.36(5), Wis. Stats., or material which can be kept confidential under the Wisconsin public records
law, must be identified on a Designation of Confidential and Proprietary Information form (DOA-3027). Bidders/proposers may request the form if
it is not part of the Request for Bid/Request for Proposal package. Bid/proposal prices cannot be held confidential.
DISCLOSURE: If a state public official (s. 19.42, Wis. Stats.), a member of a state public official's immediate family, or any organization in which a state
public official or a member of the official's immediate family owns or controls a ten percent (10%) interest, is a party to this agreement, and if this
agreement involves payment of more than three thousand dollars ($3,000) within a twelve (12) month period, this contract is voidable by the state
unless appropriate disclosure is made according to s. 19.45(6), Wis. Stats., before signing the contract. Disclosure must be made to the State of
Wisconsin Ethics Board, 44 East Mifflin Street, Suite 601, Madison, Wisconsin 53703 (Telephone 608-266-8123).
State classified and former employees and certain University of Wisconsin faculty/staff are subject to separate disclosure requirements, s. 16.417, Wis.
RECYCLED MATERIALS: The State of Wisconsin is required to purchase products incorporating recycled materials whenever technically and
economically feasible. Bidders are encouraged to bid products with recycled content which meet specifications.
MATERIAL SAFETY DATA SHEET: If any item(s) on an order(s) resulting from this award(s) is a hazardous chemical, as defined under 29CFR
1910.1200, provide one (1) copy of a Material Safety Data Sheet for each item with the shipped container(s) and one (1) copy with the invoice(s).
PROMOTIONAL ADVERTISING / NEWS RELEASES: Reference to or use of the State of Wisconsin, any of its departments, agencies or other
subunits, or any state official or employee for commercial promotion is prohibited. News releases pertaining to this procurement shall not be made
without prior approval of the State of Wisconsin. Release of broadcast e-mails pertaining to this procurement shall not be made without prior written
authorization of the contracting agency.
DOA-3027 N(R01/98)
The attached material submitted in response to Bid/Proposal #PO-1121 includes proprietary and confidential information which
qualifies as a trade secret, as provided in s. 19.36(5), Wis. Stats., or is otherwise material that can be kept confidential under the
Wisconsin Open Records Law. As such, we ask that certain pages, as indicated below, of this bid/proposal response be treated
as confidential material and not be released without our written approval.
Prices always become public information when bids/proposals are opened, and therefore cannot be kept
Other information cannot be kept confidential unless it is a trade secret. Trade secret is defined in s. 134.90(1)(c), Wis. Stats. as
follows: "Trade secret" means information, including a formula, pattern, compilation, program, device, method, technique or
process to which all of the following apply:
1. The information derives independent economic value, actual or potential, from not being generally known to, and
being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use.
2. The information is the subject of efforts to maintain its secrecy that are reasonable under the circumstances.
We request that the following pages not be released
Page #
Failure to include this form in the bid/proposal response may mean that all information provided as part of the bid/proposal response will be
open to examination and copying. The state considers other markings of confidential in the bid/proposal document to be insufficient. The
undersigned agrees to hold the state harmless for any damages arising out of the release of any materials unless they are specifically identified
Company Name
Authorized Representative
Authorized Representative
Type or Print
This document can be made available in accessible formats to qualified individuals with disabilities
Division of State Agency Services
State Bureau of Procurement
State of Wisconsin
Department of Administration
DOA-3333 (R03/2004)
Vendor Agreement
Wisconsin’s Cooperative Purchasing Service
Wisconsin statutes (s. 16.73, Wis. Stats.) establish authority to allow Wisconsin municipalities to purchase from state contracts.
Participating in the service gives vendors opportunities for additional sales without additional bidding. Municipalities use the
service to expedite purchases. A "municipality" is defined as any county, city, village, town, school district, board of school
directors, sewer district, drainage district, vocational, technical and adult education district, or any other public body having the
authority to award public contracts (s. 16.70(8), Wis. Stats.). Federally recognized Indian tribes and bands in this state may
participate in cooperative purchasing with the state or any municipality under ss. 66.0301(1) and (2), Wis.Stats.
Interested municipalities:
will contact the contractor directly to place orders referencing the state agency contract number; and
are responsible for receipt, acceptance, inspection of commodities directly from the contractor, and making payment
directly to the contractor.
The State of Wisconsin is not a party to these purchases or any dispute arising from these purchases and is not liable for
delivery or payment of any of these purchases.
The State of Wisconsin will determine the contractor’s participation by checking a box below.
MANDATORY: Bidders/Proposers must agree to furnish the commodities or services of this bid/proposal to Wisconsin
municipalities. Vendors should note any special conditions below.
OPTIONAL: Bidders/Proposers may or may not agree to furnish the commodities or services of this bid/proposal to
Wisconsin municipalities. A vendor’s decision on participating in this service has no effect on awarding this contract.
A vendor in the service may specify minimum order sizes by volume or dollar amount, additional charges beyond normal
delivery areas, or other minimal changes for municipalities.
Vendor: please check one of the following boxes in response.
I Agree to furnish the commodities or services of this bid/proposal to Wisconsin municipalities with any special
conditions noted below.
I Do Not Agree to furnish the commodities or services to Wisconsin municipalities.
Special Conditions (if applicable):
Date (mm/dd/ccyy)
Name (Type or Print)
Address (Street)
ZIP + 4
Request for Bid/Proposal Number
This form can be made available in accessible formats upon request to qualified individuals with disabilities
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