Top of Form

OMB NO. 2125-0010

<table>
<colgroup>
<col style="width: 16%" />
<col style="width: 9%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 7%" />
<col style="width: 4%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 16%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14"><p><strong>BID PRICE DATA</strong><br />
NOTE: Transmit only original to the Washington Headquarters, Office of
Infrastructure,</p>
<p>ATTN.: HIPA-10</p></td>
</tr>
<tr class="even">
<td colspan="10"> </td>
<td colspan="4">STATE</td>
</tr>
<tr class="odd">
<td colspan="3">COUNTY</td>
<td colspan="5">FEDERAL PROJECT NO.</td>
<td colspan="2">URBAN (  )<br />
RURAL  (  )</td>
<td colspan="4">DATE OF AWARD</td>
</tr>
<tr class="even">
<td>ROADWAY<br />
Contract Amount</td>
<td colspan="4">$</td>
<td colspan="4">Code Types</td>
<td colspan="5">ROADWAY AND BRIDGE</td>
</tr>
<tr class="odd">
<td>BRIDGE<br />
Contract Amount</td>
<td colspan="4">$</td>
<td colspan="9" rowspan="2"> </td>
</tr>
<tr class="even">
<td>TOTAL CONTRACT<br />
AMOUNT</td>
<td colspan="4">$</td>
</tr>
<tr class="odd">
<td rowspan="2">NUMBER OF UNITS</td>
<td rowspan="2">UNIT</td>
<td colspan="9" rowspan="2">ITEM</td>
<td colspan="2">UNIT PRICE</td>
<td rowspan="2">TOTAL COST<br />
(Dollars)</td>
</tr>
<tr class="even">
<td>Dollars</td>
<td>Cents</td>
</tr>
<tr class="odd">
<td> </td>
<td>M<sup>3</sup></td>
<td colspan="9">111 Common Roadway Excavation</td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td>M<sup>3</sup></td>
<td colspan="9">131 Unclassified Roadway Excavation <sup>1</sup></td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td>KG.</td>
<td colspan="9">421 Structural Reinforcement</td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td>KG.</td>
<td colspan="9">431 Structural steel</td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td>t</td>
<td colspan="9">775 Bituminous concrete surfaces <sup>2</sup></td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td>M<sup>2</sup></td>
<td colspan="9">781 Port. cem. conc. surfaces      CM <sup>3</sup></td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td>M<sup>3</sup></td>
<td colspan="9">900 Structural concrete <sup>3</sup></td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td> </td>
<td> </td>
<td colspan="9"> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="3">PRICE ADJUSTMENTS<br />
PCC PAVEMENTS AND<br />
STRUCTURAL CONCRETE</td>
<td colspan="5">UNIT PRICE</td>
<td colspan="7" rowspan="10"><blockquote>
<p> </p>
<p>Prepared by:______________________</p>
<p>Title:____________________________</p>
<p>Date:_____________________________</p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="3">Per Square Meter</td>
<td colspan="2">Per Cubic Meter</td>
</tr>
<tr class="odd">
<td>781</td>
<td>781</td>
<td>781</td>
<td>900</td>
<td>900</td>
</tr>
<tr class="even">
<td colspan="2">Unit bid price</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td colspan="2">Steel, not bid separately (Subtract)</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td colspan="2">Longitudinal joints (Subtract)</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td colspan="2">Transverse joints (Subtract)</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td colspan="2">Fine finishing of subgrade (Add)</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td colspan="2">Cement or aggregates bid separately (Add)</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="even">
<td colspan="2">3 ADJUSTED PRICE</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr class="odd">
<td colspan="14"><p>REMARKS (Use reverse side if more space is
needed.)</p>
<p> </p>
<p> </p>
<p> </p>
<p><sup>1</sup> Unclassified Roadway Excavation (Item 131) when
reported:<br />
_______________________________ Percent Rock</p>
<p>Estimated Price of Rock _______________________________ per cubic
meter</p>
<p><sup>2</sup> When aggregate and bituminous material are bid
separately, combine quantities and total costs. In converting liters to
metric tons, 982 liters per metric ton may be used. When bituminous
material is bid in addition to the bid for mix, report weight of mix
only, and the combined total costs.</p></td>
</tr>
</tbody>
</table>

 

+--------------------+---------------------------+--------------------+
| DISCARD BEFORE\    | DEPARTMENT OF             |   ---------------  |
| SUBMISSION         | TRANSPORTATION\           |   SUPPLEMENTAL\    |
|                    | Federal Highway           |   INFORMATION      |
|   ---------------  | Administration            |                    |
|                    |                           |   ---------------  |
|   ---------------  |                           |                    |
+--------------------+---------------------------+--------------------+
| **Agency Display   |                           |                    |
| of Estimated       |                           |                    |
| Burden\            |                           |                    |
| for\               |                           |                    |
| BID PRICE DATA**   |                           |                    |
|                    |                           |                    |
| According to the   |                           |                    |
| Paperwork          |                           |                    |
| Reduction Act of   |                           |                    |
| 1995, no persons   |                           |                    |
| are required to    |                           |                    |
| respond to a       |                           |                    |
| collection of      |                           |                    |
| information unless |                           |                    |
| it displays a      |                           |                    |
| valid OMB control  |                           |                    |
| number. The valid  |                           |                    |
| OMB control number |                           |                    |
| for this form is   |                           |                    |
| 2125-0010. The     |                           |                    |
| average completion |                           |                    |
| time for this form |                           |                    |
| is 0.75 hours. If  |                           |                    |
| you wish to make   |                           |                    |
| suggestions,       |                           |                    |
| please fax them to |                           |                    |
| 202-366-3988; or   |                           |                    |
| mail to:           |                           |                    |
|                    |                           |                    |
| > Federal Highway  |                           |                    |
| > Administration\  |                           |                    |
| > Office of        |                           |                    |
| > Program          |                           |                    |
| > Administration,  |                           |                    |
| > HIPA-10\         |                           |                    |
| > 400 7th Street,  |                           |                    |
| > SW\              |                           |                    |
| > Washington, D.C. |                           |                    |
| > 20590            |                           |                    |
+--------------------+---------------------------+--------------------+

Form FHWA-45M (Rev. 7-98) (INF 4.2, 7/29/98) PREVIOUS EDITIONS OF THIS
FORM ARE OBSOLETE

This form was electronically produced by Elite Federal Forms, Inc.