Fillable Printable Sample Request For Proposal Template

Sample Request For Proposal Template

REQUEST FOR OFFICIAL PROPOSAL FORM (R109)

Date: ________________________________

Name of Company: ______

Address:

City:

State: Zip:

Contact Person:

Phone Number: ____________________________ E-mail Address:_____________________________

Vendor Code: _____________________________

Original Signature, Title and Date

R109 form must be signed by an authorized representative of the company. In accordance with 720 CMR Section 5.04 (2) and under the

penalties and perjury, I certify that the above combination of the project value plus the firm’s uncompleted work does not exceed the firm’s

aggregate bonding capacity. CSD-681 (R109) (REV. 09/18/2012)

MASSDOT Prequalified

DCAM General Bid

DCAM Filed Sub-Bid

*DCAM General and Sub Contractors must submit an electronic copy of their DCAM Certificate of Eligibility

Project Number City/Town Project Description

Bid Opening

Date Project Value

request for obtaining bidding documents on Compact Discs free of charge for the following projects (MASSDOT projects

only). Contractors who wish to have a CD containing plans & specifications shipped to them must provide a completed mailing label

for each project with an approved carrier account number for overnight mail service to the Construction Contracts Cashiers Office,

located in room 6260 or email MassDOTBidDocuments@dot.state.ma.us

Please email the R109 form to MASSDOT at: [email protected] or mail this form to:

MASSDOT – Highway Division

Prequalification Department

10 Park Plaza, Room 6260

Boston, MA 02116

Questions? Call (857) 368 - 8660

GENERAL INSTRUCTIONS

Contractor Prequalification

In order to bid on work as a prime contractor with MASSDOT you must be prequalified in accordance with MGL Ch81,

Section 8B. You can find the application and directions on how to become prequalified on our website at:

General Bidders must be certified by DCAM in the GENERAL BUILDING CONSTRUCTION category and all

Filed-Sub Bidders must be certified by DCAM in their respective sub trade categories in order to bid on the above

project. Bidders who are not qualified will have their bids removed from consideration.

Both General and Sub Contractors intending to bid on this project must first complete a "Request for Proposal Form

"(R109 Form) and e-mail an electronic copy of both this document as well as a current DCAM Certificate of Eligibility

to the MASSDOT Director of Prequalification for approval. Please e-mail these documents to prequal.r109@state.ma.us .

Upon approval, the official bidder shall be entitled to receive an officially numbered Compact Disc (CD) containing the

plans and specifications free of charge. Other interested parties may also receive an informational copy of the CD

containing the plans and specifications free of charge. It should be noted that informational copies cannot be used for

bidding purposes. Bids shall be considered, and the contract awarded in accordance with statutes governing such

contracts, Massachusetts General Laws Chapter 149 (as amended).

All parties who wish to have the CDs shipped to them must provide a completed mailing label with an approved carrier

account number for overnight mail service (i.e. – Federal Express) to the Office of the Cashier at the address below.

Documents should be submitted to:

Cashier’s Office

MASSDOT Highway Division

10 Park Plaza - Suite 6260

Boston, MA 02116

Attn: Frank Kucharski, P. E., Construction Contracts Engineer

http://www.mhd.state.ma.us/default.asp?pgid=content/prequal02&sid=about