RFq 2015-8027; Generator Services

ATTACHMENT A
Contractors Fee Submission Form
Transfer
Switch
Manufacturer

Model

Spec

318129

$_______

189303

318131

Kohler

K-168341-225

K040536

$_______

200ROZD81

132409

338720

Kohler

K-168341-260

L.S. A1733

$_______

Kohler

50ROZJ81

189303

318130

Kohler

K-168341-150

FA95343-2

$_______

Kohler

80ROZJ

189519

338478

Kohler

K-164341-0150

K50962

$_______

Kohler

50ROZJ71

189303

318211

Kohler

K-166341-150

K43178

$_______

Kohler

80ROZJ

189546

396057

Kohler

K-564341-0260

K78698

$_______

Kohler

100ROZJ81

189629

385131

Kohler

K-168341-400

K71789

$_______

Kohler

125ROZJ81

189708

295954

ASCO

E940360047XC

36645-3001

$_______

Kohler

180ROZJ81

189928

338415

Kohler

K-168341-260

K50680

$_______

Onan

60DGCV

90379M

1970647699

Onan

07225

H970646914

$_______

Kohler

50ROZJ81

189303

318132

Kohler

K-168341-150

$_______

Generac

9A10245-S
or 3285812638

125KW

AD201267SNA

Generac
ASCO

90A04245-W
E940326097-C

K422122
994630
15672
277480
FP89241

$_______

Generac

SD0050G363

50KW

2094845

SD0050G363

$_______

Kohler

230REOZJE

Kohler

KSP-DCVA0400S

SGM3228LL

$_______

Total Annual Cost (firm, fixed price inclusive of all costs) for two maintenance services per year:
Do you offer 24-hour on call service to respond to emergencies? _____

$_______

AMP

Address

215

Trailer Mounted/
Warehouse
1088 W Liberty
Beechwood
330 Forest Ave
Maple Towers
601 Maple Ave
Riverview House
2538 Hackberry St
San Marco
1601 Madison Road
Park Eden
2610 Park Ave
President
784 Greenwood Ave
Redding Apts
3700 Reading Rd
Stanley Row 'A'
1609 Linn

215

Stanley Row 'B'-1

1609 Linn

80
211
211
212
212
213
213
213

215
216

218

AH

AH

Stanley Row 'B' -2

Pinecrest
3951 W Eighth St
Marquette/English
Woods
1999 Sutter Ave
Baldwin Grove
1111 Springfield
Pike
Reserve on S.
Martin
7363 Main Street

Manufacturer

Model

Kohler

50ROZJ

189303

Kohler

50ROZJ81

Kohler

Spec

GM66100GA4

Serial/
Accessories

SGM322DJZ

Quote for
Maintenance
for one year

Service rates: $__________/hour between 8 am and 5 pm Monday through Friday (firm, fixed rate inclusive of all costs)
$__________/hour for after hours or holidays

PARTS/SUPPLIES AND MATERIALS

Description

Percentage added to Contractors wholesale cost

Supplies and Parts

__________ %

Equipment

__________ %

On Shelf Products

__________ %

RFq 2015-8027; Generator Services

DISCOUNT OFFERED FOR EARLY PAYMENT: ______ % if invoice paid within ____ days of
properly submitted invoice as stated in the RFq.
Performance Standards.
For each time the Contractor is late to arrive for a scheduled service, the Contractors fee may be reduced
10%.
The Property Manager or Maintenance Supervisor may waive the fee reduction at their discretion after
discussing extenuating circumstances with the Contractor. Such waiver shall be in writing at the time of
the service.

RFq 2015-8027; Generator Services

PROPOSERS STATEMENT
The undersigned proposer hereby states that by completing and submitting this Form and all other
documents within this submittal, he/she is verifying that all information provided herein is, to the best of
his/her knowledge, true and accurate, and that if the Authority discovers that any information entered
herein to be false, such shall entitle the Authority to not consider or make award or to cancel any award
with the undersigned party. Further, by completing and submitting the response, the undersigned is
thereby agreeing to abide by all terms and conditions pertaining to this RFq as issued by the Authority,
either in hard copy or on the noted Internet System. Upon issuance of award to proposer, CMHA is
accepting Contractors offer contained in the submittal and this Fee Submission. No other contractual
documents will be necessary or accepted unless specifically expressed in the notification of contract
commencement. The Contract commences upon CMHAs issuance of a Notice of Contract
Commencement, which may or may not be in the form of a copy of the Contract Documents, unless said
notice expressly states otherwise, in those instances, Contract Commencement occurs in accordance with
the notification. Pursuant to all RFq Documents including attachments, this Fee Submission Form, and
pursuant to all Documents submitted, the undersigned proposes to supply the Authority with the
services described herein for the fee(s) submitted pertaining to this RFq.

Date: __________________, 2015

Company: _________________________________________________________
Address: __________________________________________________________
City, State, Zip _____________________________________________________
By: ______________________________________________________________
(Signature of Offerer)
By: _____________________________ Title: _________________________
(Print Name)
Fed Tax ID: ___________________________