Form BLR12330 "Acceptance of Proposal to Furnish Materials and Approval of Award" - Illinois

What Is Form BLR12330?

This is a legal form that was released by the Illinois Department of Transportation - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 9, 2021;
  • The latest edition provided by the Illinois Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form BLR12330 by clicking the link below or browse more documents and templates provided by the Illinois Department of Transportation.

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Download Form BLR12330 "Acceptance of Proposal to Furnish Materials and Approval of Award" - Illinois

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Acceptance of Proposal to Furnish
Materials and Approval of Award
Local Public Agency
County
Street Name/Road Name
Section Number
Bidder's Name
Bidder's Address
City
State
Zip Code
In accordance with your proposal submitted on
, a copy of which is in our files, you have been awarded the contract for
Date of Submittal
furnishing the following materials required in the
of the above designated project. Materials shall be inspected in
Construction or Maintenance
accordance with current Departmental policies.
Item
Unit of Measure
Quantity
Unit Price
Amount
Total
Terms
Shipping Instructions
For Municipal Projects
Municipal Official Signature
Date
Illinois Department of Transportation
For County And Road District Project
Concurrence in Approval of Award
Highway Commissioner Signature
Date
Regional Engineer Signature
Date
County Engineer/Superintendent of Highways
Signature
Date
Printed 07/28/21
Page 1 of 1
BLR 12330 (Rev. 06/09/21)
Acceptance of Proposal to Furnish
Materials and Approval of Award
Local Public Agency
County
Street Name/Road Name
Section Number
Bidder's Name
Bidder's Address
City
State
Zip Code
In accordance with your proposal submitted on
, a copy of which is in our files, you have been awarded the contract for
Date of Submittal
furnishing the following materials required in the
of the above designated project. Materials shall be inspected in
Construction or Maintenance
accordance with current Departmental policies.
Item
Unit of Measure
Quantity
Unit Price
Amount
Total
Terms
Shipping Instructions
For Municipal Projects
Municipal Official Signature
Date
Illinois Department of Transportation
For County And Road District Project
Concurrence in Approval of Award
Highway Commissioner Signature
Date
Regional Engineer Signature
Date
County Engineer/Superintendent of Highways
Signature
Date
Printed 07/28/21
Page 1 of 1
BLR 12330 (Rev. 06/09/21)
Instructions BLR 12330 - Page 1 of 1
The instructions should not be included when the form is submitted.
This form shall be completed by the Local Public Agency (LPA) after the material proposal or deliver and install proposal letting to notify
the material supplier of the award and how the material will be furnished. This form is not to be used where all bids are accepted from all
bidders. Material Quotations, BLR 12250, is to be used. See the Bureau of Local Roads and Streets Manual (BLRS) Chapter 12 for more
information. For signature requirements, refer to Chapter 2, Section 3.05(b) of the BLRS Manual.
Local Public Agency
Insert the name of the LPA soliciting bids for the project.
County
Insert the name of the County in which the LPA is located.
Street Name/Road Name
Insert the name of the street/road on which the project is located. For projects that include
several streets or routes insert various.
Section Number
Insert the section number assigned to this project without dashes. If there are two section
numbers assigned to the project, click on the plus sign. In the additional box labeled Section
(2) add the second section number.
Bidder
Insert the name of the successful bidder.
Address
Insert the address of the successful bidder.
Date of Submittal
Insert the date the proposal was submitted.
Construction or Maintenance
Insert the type of project this is for, construction or maintenance.
Item
Insert the name of the item.
Unit
Insert the unit of measure for the item.
Quantity
Insert the quantity of for the item.
Unit Price
Insert the awarded unit price for the item.
Amount
No entry necessary this is a calculated field, it multiplies the quantity times the unit price.
Button Functionality
Use the Add Row (+) and/or Remove Row (-) buttons located at the beginning of each line/
row to either add a row directly below the row that the Add (+) button is clicked on or remove
the actual row that the Remove (-) button is clicked on.
Terms
Insert any terms concerning this award (e.g. this could include discounts for paying within a
certain number of days).
Shipping Instructions
Insert the shipping instructions indicating a last date when the material is needed for the
minimum or maximum amount of material to be delivered.
Municipal Official
For a municipal project, the appropriate municipal LPA official will sign and date here.
Highway Commissioner
If this project is for a Road District, the Highway Commissioner will sign and date here.
County Engineer
/Superintendent of Highways
For County/Road District projects, the County Engineer/Superintendent of Highways will sign
and date here.
Regional Engineer
Upon approval the IDOT Regional Engineer will sign and date here.
A minimum of five (5) signed originals must be submitted to the Regional Engineer's District office.
Local Public Agency Clerk
Local Public Agency Engineer/Consultant
District File
District Bureau of Materials
Bidder/Contractor
Printed 07/28/21
BLR 12330 (Rev. 06/09/21)
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