Form ADM-4045 "Non-it Services - Request for Price Quote" - California

What Is Form ADM-4045?

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

Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the California 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 ADM-4045 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form ADM-4045 "Non-it Services - Request for Price Quote" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
NON-IT SERVICES - REQUEST FOR PRICE QUOTE
Page 1 of 2
ADM-4045 (NEW 11/2018)
Request for Price Quote
Notice to Bidders
You are invited to review and respond to the Non-IT Services - Request for Price Quote (RFPQ), entitled
.
In submitting your quote, you shall comply with the provisions set forth herein. The prospective Bidder must be certified by the California
Department of General Services (DGS) as a Micro Business (MB), Small Business (SB), or Disabled Veteran Business Enterprise (DVBE) to
participate.
This solicitation is authorized pursuant to Government Code Section 14838.5 and 14838.7 which provides for the award of a Service
Agreement for the acquisition of services that has an estimated value greater than $5,000.00, but less than $314,000.00 for public works, and
less than $250,000.00 for commercial services, to a certified MB, SB or DVBE.
Bidder Minimum Qualifications:
1)
2)
Time Schedule: It is recognized that time is of the essence. All bidders are hereby advised of the schedule set forth below and are expected to
adhere to the specified required dates and times below.
EVENT
DATE
TIME
RFPQ Available to Prospective Bidders
N/A
Pre-bid Site Inspection
Written Question Submittal
Quote Submission DUE Date and Time (Pacific Time)
Estimated Agreement Term Dates
Contact Information:
RETURN QUOTE AND/OR SUBMIT QUESTIONS TO:
Department of Transportation
Contract Manager's Name
District Number
Office Name
Address (Street, City, State and Zip)
Telephone Number
Fax Number
Email Address
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
NON-IT SERVICES - REQUEST FOR PRICE QUOTE
Page 1 of 2
ADM-4045 (NEW 11/2018)
Request for Price Quote
Notice to Bidders
You are invited to review and respond to the Non-IT Services - Request for Price Quote (RFPQ), entitled
.
In submitting your quote, you shall comply with the provisions set forth herein. The prospective Bidder must be certified by the California
Department of General Services (DGS) as a Micro Business (MB), Small Business (SB), or Disabled Veteran Business Enterprise (DVBE) to
participate.
This solicitation is authorized pursuant to Government Code Section 14838.5 and 14838.7 which provides for the award of a Service
Agreement for the acquisition of services that has an estimated value greater than $5,000.00, but less than $314,000.00 for public works, and
less than $250,000.00 for commercial services, to a certified MB, SB or DVBE.
Bidder Minimum Qualifications:
1)
2)
Time Schedule: It is recognized that time is of the essence. All bidders are hereby advised of the schedule set forth below and are expected to
adhere to the specified required dates and times below.
EVENT
DATE
TIME
RFPQ Available to Prospective Bidders
N/A
Pre-bid Site Inspection
Written Question Submittal
Quote Submission DUE Date and Time (Pacific Time)
Estimated Agreement Term Dates
Contact Information:
RETURN QUOTE AND/OR SUBMIT QUESTIONS TO:
Department of Transportation
Contract Manager's Name
District Number
Office Name
Address (Street, City, State and Zip)
Telephone Number
Fax Number
Email Address
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
NON-IT SERVICES - REQUEST FOR PRICE QUOTE
Page 2 of 2
ADM-4045 (NEW 11/2018)
CONTRACTOR COMPLETES SECTIONS A-G AND ALL APPLICABLE ATTACHMENTS AND SUBMITS VIA EMAIL, FAX OR MAIL
The signature and date affixed hereon certifies that this quote is a firm offer for a 90-day period.
A
B
C
CONTRACTOR NAME
INDIVIDUAL WHO IS LEGALLY AUTHORIZED TO
CALIFORNIA SMALL
BIND THE BIDDING FIRM CONTRACTUALLY
BUSINESS CERTIFICATION
PROVIDES SIGNATURE
(Check all that apply)
CONTRACTOR ADDRESS
PRINT NAME
SB
MB
DVBE
PRIME CONTRACTOR
CERTIFICATION NUMBER
TITLE
NAME OF CONTACT (First, Last)
SB
MB
DVBE
PHONE NUMBER
SUBCONTRACTOR, if applicable
DATE
SIGNATURE
CERTIFICATION NUMBER
EMAIL ADDRESS
D (Public Works Only)
E (Public Works Only)
F
CONTRACTOR STATE LICENSE BOARD (CSLB)
DEPARTMENT OF INDUSTRIAL RELATIONS (DIR)
PRICE QUOTE TOTAL:
LICENSE REQUIRED
REGISTRATION NUMBER
$
CSLB LICENSE NUMBER
SUB CONTRACTOR REGISTRATION NUMBER
G (Public Works Only)
1. IF WINNING BIDDER'S BID EXCEEDS $25,000.00, BIDDER WILL BE REQUESTED TO FURNISH A PAYMENT BOND FOR 100% OF
BID AMOUNT
2. BIDDER ACKNOWLEDGES PREVAILING WAGE IS MANDATED IF BID IS $15,000.00 OR OVER
Bidder acknowledges that State General Prevailing Wage Rates will apply for the County(ies) of
throughout the duration of this Agreement. It is my responsibility as the prime bidder to ascertain and use the correct classification
determination published by the Department of Industrial Relations. If awarded this Agreement, I acknowledge that it will be my
responsibility to ensure the payment of appropriate prevailing wage rates required to all employees who participate on this
Agreement.
Initial Here:
ASSOCIATED EXHIBITS AND CONTRACT ATTACHMENTS
Exhibits and Attachments:
• Exhibit A - Scope of Work (Attached to this RFPQ)
• Exhibits B, D and E - RFPQ Special Terms and Conditions can be viewed at:
http://dot.ca.gov/dpac/doc/exhibit-bde.pdf
• Exhibit C - General Terms and Conditions (GTC 04/2017) can be viewed at:
http://dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx
• Contractor's Certification Clauses (CCC 04/2017) can be viewed at:
http://dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx
Bidder Required Documents Checklist
Instructions to Caltrans Contract Manager: (Check all that apply)
Bidder should return the completed documents listed below with this form.
Price Quote Proposal ADM-1412
Bidder Declaration Form (GSPD-05-105) (if applicable) Subcontractors certified as MB, SB and/or DVBE must provide a commercially useful
function as defined in Military and Veterans Code Section 999(e)(2)(A) for DVBEs and Government Code Section 14837(d)(4)(A) for SB/
MBs. Any subcontractors must be a certified SB/MB or DVBE.
Non-Collusion Declaration for Public Works (if applicable)
Darfur Contracting Act Certification
California Civil Rights Laws Certification (if $100,000 or over)
Motor Carrier Permit (if applicable)
WHEN SUBMITTING A PRICE QUOTE, BIDDER (CONTRACTOR) CERTIFIES THAT (1) ALL REQUIRED ATTACHMENTS ARE INCLUDED
WITH THIS PRICE QUOTE, (2) THE SIGNATURE AND DATE AFFIXED HEREON CERTIFIES AND VERIFIES COMPLIANCE WITH ALL THE
REQUIREMENTS OF THIS PRICE QUOTE DOCUMENT.
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
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