APPENDIX A BID FORM ITB #201433



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APPENDIX A BID FORM ITB #201433 (a) (b) (c) The Contractor shall fill out the table below of rates that will be charged for work completed under this Contract. This Bid Table shall be included within the proposal submitted to the City. There is no guarantee regarding the amount of work that will be completed under this contract. Any items not listed or described in the Bid Table will be negotiated between the City and the Contractor at the time of need. Once a negotiated price is established, it will be used for the remainder of the contract. Asphalt Mix F.O.B. Destination (Placement anywhere within the City of Winchester or City owned facilities): The City is requesting delivered and placed per ton rates to furnish all labor, equipment, materials, transportation and traffic control, and these rates shall be binding upon award. Any bidder who enters a $0.00 per ton rate or leaves it blank shall be considered non-responsive. PRICE SCHEDULE A Asphalt Placement Monday Friday, 6:00 am 8:00 pm of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.SAL Final Surface Course 10,000 tons Course [Prior to SM-9.5AL 4,000 tons ~ 5 3cç9 qoo, BM-25.OA Base Course 1,000 tons.st~ ~ 3, SZDO. TOTAL-PRICESCHEDULEA 1, ~0?, 9co. ~ ~o TB #201433 24

Asphalt Mix PRICE SCHEDULE B Asphalt Placement Night Paving or Weekends Monday Friday, 8:00 pm 6:00 am Saturday Sunday, Anytime (both am and pm) of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.SAL Final Surface Course 3,000 tons ~9 7 i4 9 ç~ SM -9.5AL Course [Prior to 1,000 tons ~?9t ~J~SZ~ ~ ~ TOTAL - PRICE SCHEDULE B (Nights and Weekends) 3(c J, ~ ~, PRICE SCHEDULE C Asphalt Planing (Milling) Note: Prices shall include hauling asphalt millings to City Yards (301 E. Cork Street) and placed in a pile for future use by the City. Item Unit Cost ($/sq. yd.) Total Cost ($) 30,000 sq. yds. Asphalt Pavement Planing (Milling) (Up to 2-inch s.c /O~ c-c~o. depth removal) 10,000 sq. yds. Asphalt Pavement Planing (Milling) (2-inchto4- :3 ~ inch depth removal) TOTAL - PRICE SCHEDULE C (Asphalt Planing) / L_J 3 ~ ~.(, BID SUMMARY ASPHALT PLACEMENT TOTAL-PRICESCHEDULEA TOTAL - PRICE SCHEDULE B (Nights and Weekends) ~f ~ ~Q TOTAL - PRICE SCHEDULE C (Asphalt Planing) / c~( 3, coo. a~ TOTALFORALL(A+B C) j~77~2.oo ITB #201433 25

OPTIONAL - PRICE SCHEDULE D Asphalt Materials Only (Prices shall be for City to pick up material at the contractor s plant) Note: Providing pricing for this schedule is optional. The City may award separate contracts for asphalt placement and asphalt materials. Item. Unit Cost ($/ton) Total Cost ($) Hot Mix Asphalt: SM-9.5AL 1,000 tons, 5a(.) - Hot Mix Asphalt: BM-25.0A 400 tons ~ U, (~ 00 TOTAL - PRICE SCHEDULE D (Asphalt Materials Only) / 00 (o~d Qi.jO~~~ ~ ~~ z Specify Location of Contractor s Asphalt Plant: C. Ie~_j.6CG,OJC~~ ~ ~ ~ ( COMPANY NAME: LLI- L. C ~ ô~i ADDRESS: ~ //(~cb~ P,k~ S~h J~Ics~, (P~o.i~ TELEPHONE NUMBER: ~Y(2 - ~o&3 ~ E-MAIL ADDRESS: ~ (~j4~.( ~ ~ (2c~ f ~p ~4~-ii ~+~; ~ NAME AND TITLE: (~ \S~P~~ ~ DATE: (~ ~ / - C~ O vy~ ~. SIGNATURE: ~ I I By signing this bid sheet, bic~ier ac~kdov~.a(ecj~ies that he completely understands all specifications and the General and Special conditidns. Failure to c~ompletely fill out the Bid Form (both pages) will result in a non-responsive bid. TB #201433 26

APPENDIX A BID FORM ITB #201433 (a) (b) (c) The Contractor shall fill out the table below of rates that will be charged for work completed under this Contract. This Bid Table shall be included within the proposal submitted to the City. There is no guarantee regarding the amount of work that will be completed under this contract. Any items not listed or described in the Bid Table will be negotiated between the City and the Contractor at the time of need. Once a negotiated price is established, it will be used for the remainder of the contract. Asphalt Mix F.O.B. Destination (Placement anywhere within the City of Winchester or City owned facilities): The City is requesting delivered and placed per ton rates to furnish all labor, equipment, materials, transportation and traffic control, and these rates shall be binding upon award. Any bidder who enters a $0.00 per ton rate or leaves it blank shall be considered non-responsive. PRICE SCHEDULE A Asphalt Placement Monday Friday, 6:00 am 8:00 pm of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.5AL Final Surface Course 10,000 tons ~ 1 ~(~8I ~,SO1L ~ SM-9.5AL Course [Prior to 4,000 tons ~ 1$ BM-25.OA Base Course 1,000 tons ~ (~,9 L~IE 000 TOTAL-PRICESCHEDULEA ~J~ O~1~j~ ITB #201433 24

PRICE SCHEDULE B Asphalt Placement Night Paving or Weekends Monday Friday, 8:00 pm 6:00 am Saturday Sunday, Anytime (both am and pm) Asphalt Mix I of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.5AL Final Surface Course 3,000 tons $7~, ~S ~ 2l~ ~ SM-9.5AL Course [Priorto 1,000 tons S 7~4~~5 ~7 1~ ~5O ~ TOTAL - PRICE SCHEDULE B (Nights and Weekends) $ PRICE SCHEDULE C Asphalt Planing (Milling) Note: Prices shall include hauling asphalt millings to City Yards (301 E. Cork Street) and placed in a pile for future use by the City. Item Estimad Unit Cost ($/sq. yd.) Total Cost ($) Asphalt Pavement Planing (Milling) 30,000 sq. yds. (Up to 2-inch ~ ~ ~fi(~,9 ~oo depth removal) 1 10,000 sq. yds.... Asphalt Pavement Planing (Milling) (2-inchto4- inch depth ~3 3L4 sy #33~ ~ ~ removal) TOTAL - PRICE SCHEDULE C (Asphalt Planing) 41)o3~ 2.00. ~ BID SUMMARY ASPHALT PLACEMENT TOTAL- PRICESCHEDULEA ~~/c~q Iob~ TOTAL - PRICE SCHEDULE B (Nights and Weekends).11 ~Q3 ~I~0 TOTAL - PRICE SCHEDULE C (Asphalt Planing) -~ /O3~ 20D. ~> TOTAL FOR ALL (A + B + C) ~ijq3~ 7~<~ ITB#201433 25

OPTIONAL - PRICE SCHEDULE D Asphalt Materials Only (Prices shall be for City to pick up material at the contractor s plant) Note: Providing pricing for this schedule is optional. The City may award separate contracts for asphalt placement and asphalt materials. Item ~ Unit Cost ($/ton) Total Cost ($) Hot Mix Asphalt: SM-9.5AL 1,000 tons ~ /5 * ~L,Z, ISO. HotMixAsphalt: BM-25.OA 400tons ~ 15 ê~qc,. O,~0 TOTAL PRICE SCHEDULE D (Asphalt Materials Only) 117 ~fwe t-4ue Specify Location of Contractor s Asphalt Plant: tu ~4Lk~s1t~a v ft 4o~L COMPANYNAME: 5~up~c~4,& ADDRESS: WI L~r~ ~ ~~ie 2ZL~f~7 TELEPHONENIJMBER: S~tO~ ~G,23L13j ~f 1Z-L E-MAIL ADDRESS:,1 \~J E354 4~-~.p~ rwy NAME AND TITLE: ~ ~ ~ z~2 DATE: /Zo-r~2 // SIGNATURE: ~1 ~_f:~::.::: J1~2f4~1 By signing this bid sheet, bidder acknowledges that he completely understands all specifications and the General and Special conditions. Failure to completely fill out the Bid Form (both pages) will result in a non-responsive bid. ITB#201433 26

APPENDIX A BID FORM ITB #201433 (a) (b) (c) The Contractor shall fill out the table below of rates that will be charged for work completed under this Contract. This Bid Table shall be included within the proposal submitted to the City. There is no guarantee regarding the amount of work that will be completed under this contract. Any items not listed or described in the Bid Table will be negotiated between the City and the Contractor at the time of need. Once a negotiated price is established, it will be used for the remainder of the contract. Asphalt Mix F.O.B. Destination (Placement anywhere within the City of Winchester or City owned facilities): The City is requesting delivered and placed per ton rates to furnish all labor, equipment, materials, transportation and traffic control, and these rates shall be binding upon award. Any bidder who enters a $0.00 per ton rate or leaves it blank shall be considered non-responsive. PRICE SCHEDULE A Asphalt Placement Monday Friday, 6:00 am 8:00 pm of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.5AL Final Surface Course 10,000 tons Sb gy 0 o ~ ~ ôo~ SM-9,5AL Course [Prior to 4,000 tons ~ 0 ~ BM-25.OA Base Course 1,000tons 0 C ~ OOC) TOTAL-PRICESCHEDULEA ~!/.2(OO~OOO ITB#201433 24

Asphalt Mix PRICE SCHEDULE B Asphalt Placement Night Paving or Weekends Monday Friday, 8:00 pm 6:00 am Saturday Sunday, Anytime (both am and pm) of Placement Unit Cost ($/Ton) Total Cost ($) SM-9.5AL Final Surface Course 3,000 tons,~ ~ ~ 0O 0 SM-9.5AL Course [Prior to 1,000 tons ~ ~,00 $ cc~ O TOTAL - PRICE SCHEDULE B (Nights and Weekends) ~ 33~ / PRICE SCHEDULE C Asphalt Planing (Milling) Note: Prices shall include hauling asphalt millings to City Yards (301 E. Cork Street) and placed in a pile for future use by the City. Item ~ Unit Cost ($/sq. yd.) Total Cost ($) 30,000 sq. yds. ~ Asphalt Pavement Planing (Milling) (Up to 2-inch 1 0 o o depth removal) 10,000 sq. yds. Asphalt Pavement Planing (Milling) (2-inch to 4- ~j ~ ~ removal) TOTAL - PRICE SCHEDULE C (Asphalt Planing) \Q 0 I BID SUMMARY ASPHALT PLACEMENT TOTAL-PRICE SCHEDULE A ~ 1,, c2.(qo/ 000 TOTAL - PRICE SCHEDULE B (Nights and Weekends) ~. 33~, c~ô o TOTAL - PRICE SCHEDULE C (Asphalt Planing) ) 03, 00 0 TOTAL FORALL(A+B+C) ~1 ITB#201433 25

OPTIONAL - PRICE SCHEDULE D Asphalt Materials Only (Prices shall be for City to pick up material at the contractor s plant) Note: Providing pricing for this schedule is optional. The City may award separate contracts for asphalt placement and asphalt materials. Item Unit Cost ($/ton) Total Cost ($) Hot Mix Asphalt: SM-9,5AL 1,000 tons ~ (g~~. 00 ~ Hot Mix Asphalt: BM-25.OA 400 tons ~ (ç~ ~,. ~,~ TOTAL - PRICE SCHEDULE D (Asphalt Materials Only) ~ ~, ~ ~..o o // p ~~rmf5tr~ic t,4~cj~: Specify Location of Contractor s Asphalt Plant:~ ~ COMPANY NAME: 42.T~o~ (OAT~J CO., ~ ADDRESS: ~3~1 l~ 0 U~ lasj 04Z - ~u LL~ S, ~,Eh& p.c) J ~$ TELEPHONE NUMBER: (?o3) ~ ~ i;ss E-MAIL ADDRESS: ~VF THU Z(J)AJ T. CO ~& NAMEANDTITLE: E~3~D I4~AO O ~/i~?s.rjc-~j--r By signing this bid sheet, bidder acknowledges that he completely understands all specifications and the General and Special conditions. Failure to completely fill out the Bid Form (both pages) will result in a non-responsive bid. TB #201433 26