ATTACHMENT U.4
BID FORM
AND
SCHEDULE OF PRICES
Company Name: ____________________________________________
Page 1 of 5
IFB No. 016-018
Delivery of LED Lights
Virginia Railway Express
A.
BID CERTIFICATION
By my signature, I certify that I am authorized to bind this company/individual to provide the
goods/services specified herein, in compliance with the scope of work/technical
specifications, and other terms and conditions in this Invitation for Bids at the price provided
in the Bid Form.
Signature _____________________________Print ____________________________________
Title ___________________________________ Date ___________________________________
Firm Name______________________________________________________________________
Address_________________________________________________________________________
City, State ________________________________Zip Code______________________________
Phone Number ____________________________Email_________________________________
Page 2 of 5
IFB No. 016-018
Delivery of LED Lights
Virginia Railway Express
B.
BID FORM
DELIVERY OF LED LIGHTS
TOTAL PRICE
TOTAL PRICE FROM SCHEDULE OF PRICES
(Items 1 - 7)
$___________________
Company Name: ____________________________________________
Page 3 of 5
IFB No. 016-018
Delivery of LED Lights
Virginia Railway Express
C.
SCHEDULE OF PRICES – Base Order
Failure to provide a unit price will result in the Bid being deemed non-responsive.
The Bidder shall state the manufacturer or brand name and part number of the product
offered and provide descriptive literature only if the product being offered is other than what is
specified herein. See Section H.12 and H.13 herein.
The unit price shall be inclusive of all shipping and delivery charges. See Section R.1G.
A
B
C
(A x B)
Item
No.
Description
Quantity
Unit Price
Price
1.
Lamp
King Luminaire
K705-P4SA-III-75(SSL)-7030-120-KPL10-xxx-BN
or approved equal
29
$__________
$___________
19
$___________
$___________
19
$___________
$___________
_________________________________
(Brand name and part number offered)
Arm
King Luminaire KA78-T-1 or approved equal
2.
_________________________________
(Brand name and part number offered)
Pole
King Luminaire KM10RE-11 or approved equal
3.
_________________________________
(Brand name and part number offered)
TOTAL PRICE FOR BASE ORDER (Items 1 – 3)
$________________________________
NOTE: Contract award will be based on the Total Price for the Base Order and Option Order.
Company Name: ____________________________________________
Page 4 of 5
IFB No. 016-018
Delivery of LED Lights
Virginia Railway Express
D.
SCHEDULE OF PRICES – Option Order
Failure to provide a unit price will result in the Bid being deemed non-responsive.
The Bidder shall state the manufacturer or brand name and part number of the product
offered and provide descriptive literature only if the product being offered is other than what is
specified herein. See Section H.12 and H.13 herein.
The unit price shall be inclusive of all shipping and delivery charges. See Section R.1G.
A
B
C
(A x B)
Item
No.
Description
Quantity
Unit Price
Price
4.
Lamp
King Luminaire
K705-P4SA-III-75(SSL)-7030-120-KPL10-xxx-BN
or approved equal
250
$__________
$___________
150
$___________
$___________
150
$___________
$___________
250
$___________
$___________
_________________________________
(Brand name and part number offered)
Arm
King Luminaire KA78-T-1 or approved equal
5.
_________________________________
(Brand name and part number offered)
Pole
King Luminaire KM10RE-11 or approved equal
6.
_________________________________
(Brand name and part number offered)
Wall Sconce
Vinci-LED-20-50-UNV-BZ or approved equal
7.
_________________________________
(Brand name and part number offered)
TOTAL PRICE FOR OPTION ORDER (Items 4 – 7)
$_____________________________
NOTE: Contract award will be based on the Total Price for the Base Order and Option Order.
Company Name: ____________________________________________
Page 5 of 5
IFB No. 016-018
Delivery of LED Lights
Virginia Railway Express