Program: 867‐S

Term: Date of Award to June 30, 2016

Title: Senate Disbursing Office Check Stub Forms

BASIS OF

ITEM NO. DESCRIPTION AWARD UNIT RATE COST UNIT RATE COST 

I. COMPLETE PRODUCT:

Per Product..................................................................

(1) Make‐ready and/ or Setup..................................... 2 No Charge $0.00 No Charge $0

(2) Running Per 1,000 Copies........................................ 200 $57.81 $11,562.00 $120.00 $24,000

CONTRACTOR TOTALS $11,562.00 $24,000

DISCOUNT 0.00% $0.00 0.00% $0

DISCOUNTED TOTALS $11,562.00 $24,000

AWARDED

RR. DONNELLEY

CHEVY CHASE, MD

STANDARD REGISTER

DAYTON, OH
Program 867-S Page 1 of 12 

Specifications by DLL 

U.S. GOVERNMENT PRINTING OFFICE 

Washington, DC 

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

For the Procurement of 

Senate Disbursing Office Check Stub Forms 

as requisitioned from the U.S. Government Printing Office (GPO) by the 

Office of the Secretary of the Senate 

Single Award 

CONTRACT TERM: The term of this contract is for the period beginning Date of Award and ending 

June 30, 2016, plus up to four (4) optional 12-month extension period(s) that may be added in accordance with the 

“OPTION TO EXTEND THE CONTRACT TERM” clause in SECTION 1 of this contract. 

BID OPENING: Bids shall be publicly opened at 11:00 a.m., prevailing Washington, DC, time, on July 7, 2015 

BID SUBMISSION: Submit bid in pre-addressed envelope furnished with solicitation or send to: U.S. Government 

Printing Office, Bid Section, Room C-831, Stop: PPSB, 732 North Capitol Street, NW, Washington, DC 20401. 

Facsimile bids in response to this solicitation are permitted. Facsimile bids may be submitted directly to the GPO 

Bid Section, Fax No. (202) 512-1782. The program number and bid opening date must be specified with the bid. 

Refer to Facsimile Bids in Solicitation Provisions of GPO Contract Terms, GPO Publication 310.2, as revised June 

2001. Hand delivered bids are to be taken to The GPO Bookstore at 710 North Capitol Street, NW, Washington, DC 

between the hours of 8:00 am and 4:00 pm on business days and follow the instructions in the Bid 

Submission/Opening area. If further instruction or assistance is needed, call 202-512-0526. 

PRODUCTION AREA: It is assumed that all production facilities used in the manufacture of the products ordered 

under this contract will be located within a 60-mile radius of zero milestone Washington, DC. 

Any bidder intending to use production facilities outside this area should furnish information, with the bid, which 

will on its face demonstrate ability to meet the schedule requirements. The determination by the Government of the 

acceptability of this information in no way relieves the successful bidder of the responsibility for compliance with 

these schedule requirements. 

Abstracts of contract prices are available at http://www.gpo.gov/gpo/abstracts/abstract.action?region=DC

For information of a technical nature call David Love (202) 512-0310 (No collect calls).
Senate Disbursing Office Check Stub Forms Page 2 of 12 

867-S (6/16) 

SECTION 1. – GENERAL TERMS AND CONDITIONS

GPO CONTRACT TERMS: Any contract which results from this Invitation for Bid will be subject to the 

applicable provisions, clauses, and supplemental specifications of GPO Contract Terms (GPO Publication 310.2, 

effective December 1, 1987 (Rev. 6-01)) and GPO Contract Terms, Quality Assurance through Attributes Program 

for Printing and Binding (GPO Publication 310.1, effective May 1979 (Rev. August 2002)). 

GPO Contract Terms (GPO Publication 310.2) – http://www.gpo.gov/pdfs/vendors/sfas/terms.pdf

GPO QATAP (GPO Publication 310.1) – http://www.gpo.gov/pdfs/vendors/sfas/qatap.pdf

DISPUTES: GPO Publication 310.2, GPO Contract Terms, Contract Clause 5. Disputes, is hereby replaced with 

the June 2008 clause found at www.gpo.gov/pdfs/vendors/contractdisputes.pdf. This June 2008 clause also cancels 

and supersedes any other disputes language currently included in existing contractual actions. 

GPO IMPRINT REQUIREMENT: The GPO imprint requirement, GPO Contract Terms, Supplemental 

Specification, No. 9, is waived. 

QUALITY ASSURANCE LEVELS AND STANDARDS: The following levels and standards shall apply to these 

specifications: 

Product Quality Levels: 

 (a) Printing (page related) Attributes -- Level III. 

 (b) Finishing (item related) Attributes -- Level III. 

Inspection Levels (from ANSI/ASQC Z1.4): 

 (a) Non-destructive Tests - General Inspection Level I. 

 (b) Destructive Tests - Special Inspection Level S-2. 

Specified Standards: The specified standards for the attributes requiring them shall be: 

 Attribute Specified Standard 

P-7. Type Quality and Uniformity Furnished Sample 

P-9. Solid and Screen Tint Color Match Pantone Matching System 

OPTION TO EXTEND THE CONTRACT TERM: The Government has the option to extend the term of this 

contract for a period of 12 months by written notice to the contractor not later than 30 days before the contract 

expires. If the Government exercises this option, the extended contract shall be considered to include this clause, 

except, the total duration of the contract may not exceed five (5) years as a result of, and including, any extension(s) 

added under this clause. Further extension may be negotiated under the “EXTENSION OF CONTRACT TERM” 

clause. See also “ECONOMIC PRICE ADJUSTMENT” for authorized pricing adjustment(s). 

EXTENSION OF CONTRACT TERM: At the request of the Government, the term of any contract resulting 

from this solicitation may be extended for such period of time as may be mutually agreeable to the GPO and the 

contractor. 

ECONOMIC PRICE ADJUSTMENT: The pricing under this contract shall be adjusted in accordance with this 

clause, provided that in no event will any pricing adjustment be made that would exceed the maximum permissible 

under any law in effect at the time of the adjustment. There will be no adjustment for orders placed during the first 

period specified below. Pricing will thereafter be eligible for adjustment during the second and any succeeding 

performance period(s). 
Senate Disbursing Office Check Stub Forms Page 3 of 12 

867-S (6/16) 

For each performance period after the first, a percentage figure will be calculated as described below and that figure 

will be the economic price adjustment for that entire next period. Pricing adjustments under this clause are not 

applicable to reimbursable postage or transportation costs, or to paper, if paper prices are subject to adjustment by 

separate clause elsewhere in this contract. 

For the purpose of this clause, performance under this contract will be divided into successive periods. The first 

period will extend from Date of Award to June 30, 2016, and the second and any succeeding period(s) will extend 

for 12 months from the end of the last preceding period, except that the length of the final period may vary. The 

first day of the second and any succeeding period(s) will be the effective date of the economic price adjustment for 

that period. 

Pricing adjustments in accordance with this clause will be based on changes in the seasonally adjusted “Consumer 

Price Index For All Urban Consumers – Commodities less Food” (Index) published monthly in the CPI Detailed 

Report by the U.S. Department of Labor, Bureau of Labor Statistics. 

The economic price adjustment will be the percentage difference between Index averages as specified in this 

paragraph. An index called the variable index will be calculated by averaging the monthly Indexes from the 12-

month interval ending three (3) months prior to the beginning of the period being considered for adjustment. This 

average is then compared to the average of the monthly Indexes for the 12-month interval ending 

March 31, 2015, called the base index. The percentage change (plus or minus) of the variable index from the base 

index will be the economic price adjustment for the period being considered for adjustment. 

The Government will notify the contractor by contract modification specifying the percentage increase or decrease 

to be applied to invoices for orders placed during the period indicated. The contractor shall apply the percentage 

increase or decrease against the total price of the invoice less reimbursable postage or transportation costs and 

separately adjusted paper prices. Payment discounts shall be applied after the invoice price is adjusted. 

PREAWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, the 

Government reserves the right to conduct an on-site pre-award survey at the contractor’s/subcontractor’s facility or 

to require other evidence of technical, production, managerial, financial, and similar abilities to perform, prior to the 

award of a contract. 

PREAWARD TEST: The contractor being considered for award shall be required to demonstrate their ability to 

print the items required in these specifications at the requisite quality level by completing a pre-award test. 

NOTE: The Government reserves the right to waive the pre-award test if there is other evidence that, in the opinion 

of the Contracting Officer, indicates that the contractor being considered for award has the capability to successfully 

produce the items required. 

For the pre-award test, the Government will furnish one (1) previously printed sample (printed face and back) to be 

used as a visual and construction guide. 

The prospective contractor shall provide 1,000 pre-award test samples. 

Each sample shall be printed and constructed in accordance with SECTION 2. – SPECIFICATIONS, and must be of 

the size, kind, and quality that the contractor will furnish. Pre-award test samples must be printed on White High 

Quality Xerographic Copier, Laser Printer, basis weight: 28 lbs. per 500 sheets, 17 x 22”, equal to JCP Code O-61, 

as specified herein. 

Samples will be inspected and tested and must comply with the specifications as to construction, kind, and quality of 

materials. The samples will be tested for conformance of materials and/or construction requirements. Samples will 

be tested on specified equipment to ensure successful usage under normal operating conditions (see “EQUIPMENT 

COMPATIBILITY” specified herein). 

NOTE: Final product must match furnished sample exactly, including glue. 

The contractor shall submit the pre-award test samples to: U.S. Government Printing Office, Central Receiving, 

Attn: Congressional Publishing Service (Cathy DeVinney/Lyle Green), 44 H Street, NW, Washington, DC 20401. 
Senate Disbursing Office Check Stub Forms Page 4 of 12 

867-S (6/16) 

Contractor must submit samples within three (3) workdays of receipt of test materials. 

If the pre-award test samples are disapproved by the Government, the Government, at its option, may require the 

contractor to submit revised samples for evaluation. The contractor shall submit these revised samples within 

three (3) workdays upon notification of the required changes. 

In the event the revised test samples are disapproved by the Government, the contractor shall be deemed to have 

failed to comply with the applicable requirements of these specifications and may be reason for a determination of 

non-responsibility. 

All samples shall be manufactured at the facilities in which the contract production quantities are to be 

manufactured. 

No charges will be allowed for costs incurred in the performance of this pre-award test. 

ASSIGNMENT OF JACKETS, PURCHASE AND PRINT ORDERS: A GPO jacket number will be assigned 

and a purchase order issued to the contractor to cover work performed. The purchase order will be supplemented by 

an individual print order for each job placed with the contractor. The print order, when issued, will indicate the 

quantity to be produced and any other information pertinent to the particular order. 

ORDERING: Items to be furnished under the contract shall be ordered by the issuance of print orders by the 

Government. Orders may be issued under the contract from Date of Award through June 30, 2016, plus for such 

additional period(s) as the contract is extended. All print orders issued hereunder are subject to the terms and 

conditions of the contract. The contract shall control in the event of conflict with any print order. A print order 

shall be “issued” for purposes of the contract, when it is either deposited in the U.S. Postal Service mail or otherwise 

furnished to the contractor in conformance with the schedule. 

REQUIREMENTS: This is a requirements contract for the items and for the period specified herein. 

Shipment/delivery of items or performance of work shall be made only as authorized by orders issued in accordance 

with the clause entitled “ORDERING.” The quantities of items specified herein are estimates only, and are not 

purchased hereby. Except as may be otherwise provided in this contract, if the Government's requirements for the 

items set forth herein do not result in orders in the amounts or quantities described as “estimated,” it shall not 

constitute the basis for an equitable price adjustment under this contract. 

Except as otherwise provided in this contract, the Government shall order from the contractor all the items set forth 

which are required to be purchased by the Government activity identified on page 1. 

The Government shall not be required to purchase from the contractor, requirements in excess of the limit on total 

orders under this contract, if any. 

Orders issued during the effective period of this contract and not completed within that time shall be completed by 

the contractor within the time specified in the order, and the rights and obligations of the contractor and the 

Government respecting those orders shall be governed by the terms of this contract to the same extent as if 

completed during the effective period of this contract. 

If shipment/delivery of any quantity of an item covered by the contract is required by reason of urgency prior to the 

earliest date that shipment/delivery may be specified under this contract, and if the contractor will not accept an 

order providing for the accelerated shipment/delivery, the Government may procure this requirement from another 

source. 

The Government may issue orders which provide for shipment/delivery to or performance at multiple destinations. 

Subject to any limitations elsewhere in this contract, the contractor shall furnish to the Government all items set 

forth herein which are called for by print orders issued in accordance with the “ORDERING” clause of this contract. 
Senate Disbursing Office Check Stub Forms Page 5 of 12 

867-S (6/16) 

SECTION 2. – SPECIFICATIONS

SCOPE: These specifications cover the production of check stub forms requiring such operations as printing, 

construction, packing, and distribution. 

TITLE: Senate Disbursing Office Check Stub Forms. 

FREQUENCY OF ORDERS: Approximately 2 orders per year. 

QUANTITY: Approximately 100,000 copies per order. 

NUMBER OF PAGES: Face and back. 

TRIM SIZE: 8-1/2 x 11”. 

GOVERNMENT TO FURNISH: One (1) previously printed sample (printed face and back) to be used as a visual 

and construction guide. 

One reproduction proof, Form 905 (R. 6/03), with labeling and marking specifications. 

A supply of blue labels and selection certificates for shipping Departmental Random copies. 

Identification markings such as register marks, commercial identification marks of any kind, etc., must not print on 

the finished product. 

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “GOVERNMENT 

TO FURNISH,” necessary to produce the product(s) in accordance with these specifications. 

NOTE: Final product must match sample exactly, including glue. 

PROOFS: 

NOTE: Proofs will be required on the first print order only. 

One (1) set of digital color content proofs. 

Proofs shall be collated with all elements in proper position (not pasted up), imaged face and back, trimmed and 

folded to the finished size of the product. Direct to plate must be used to produce the final product with a minimum 

of 2400 x 2400 dpi. Proofs must be created using the same Raster Image Processor (RIP) that will be used to 

produce the product. 

If any contractor’s errors are serious enough in the opinion of the GPO to require revised proofs, the revised proofs 

are to be provided at no expense to the Government. No extra time can be allowed for this reproofing; such 

operations must be accomplished within the original production schedule allotted in the specifications. 

Contractor must not print prior to the receipt of an “O.K. to Print.” 

STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein or listed 

for the corresponding JCP Code numbers in the “Government Paper Specification Standards No. 12” dated February 

2008. 

Government Paper Specification Standards No. 12: http://www.gpo.gov/acquisition/paperspecs_vol12.htm. 

White High Quality Xerographic Copier, Laser Printer, basis weight: 28 lbs. per 500 sheets, 17 x 22”, equal to JCP 

Code O-61. 
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867-S (6/16) 

PRINTING: Print face and back in Pantone 286 (Blue). 

Printing on face consists of type and line matter and two jumbled character blockout areas. One blockout area is 

approximately 7-5/8 x 3-3/16”, approximately 3/8” from top edge of form. The other blockout area is approximately 

7-5/8 x 3-3/16”, approximately 7-3/8” from top edge of form (follow furnished sample). 

Printing on back consists of type and line matter only (follow furnished sample). 

MARGINS: Margins will be as specified on the print order or furnished sample. 

CONSTRUCTION: Follow furnished sample for the following – 

Perforate (slit or slot without ink) vertically along the entire 11” dimension, 3/8” from the left and right edges. 

Perforate (slit or slot without ink) horizontally along the entire 8-1/2” dimension using a fine (dot) perforation at 3-

5/8” and 7-3/8” from the top edge of form (to facilitate folding). 

Back of Form – 

Apply pressure seal glue (approximately 3/4 x 1/4”) on back in four places, centered on the 8-1/2” dimension 

(between vertical perforations), 1/8” from bottom edge of form. 

Apply pressure seal glue (approximately 1/8 x 1/2”) on back in nine places along both the right and left edges. Glue 

is to be vertical, 3/16” from outside edges, centered along the 11” dimension. 

Face of Form – 

Apply pressure seal glue (approximately 3/4 x 1/4”) on face in four places, centered on the 8-1/2” dimension 

(between vertical perforations), 3-3/16” from top edge of form. 

Apply pressure seal glue (approximately 1/8 x 1/2”) on face in three places along both the right and left edges. Glue 

is to be vertical, 3/16” from outside edges, at 9/16”, 1-7/8”, and 3-3/16” from top edge of form. 

Adhesive used in the production of the check stub form must meet the requirements set forth in the USPS Physical 

Standards for Machinable Letters and Cards. Glue (continuous or spot) may be used as applicable to the particular 

type of mail piece under USPS Physical Standards. The sealing devices must not interfere with the recognition of 

the bar code, price marking, postage information, or delivery or return addresses. In all cases, no additional tabs or 

seals may be used. Cellophane tape is not acceptable within the bar code clear zone. The quantity of adhesive and 

the strength of the seal must be sufficient to maintain the integrity of the piece throughout the mailing and delivery 

process. 

EQUIPMENT COMPATIBILITY: Forms must be compatible with the following equipment – 

PSMailers 7K Plus Modified. Speed – 11,000 per hour, double detection, 36” conveyor. 

Adhesive used on forms must be pressure seal glue suitable for use on a High Speed Xerox Laser Printer. 

Forms must be guaranteed to function on PSMailers 7K Plus Modified and High Speed Xerox Laser Printer.

PACKING: Pack suitable in shipping containers in units of 1,000 forms. Check stub forms must be packed flat. 

All shipments which fill less than a shipping container must be packaged with materials of sufficient strength and 

durability and in such a manner which will guarantee that the product will not be damaged and the package will not 

open nor split when processed through a small package carrier delivery system. 
Senate Disbursing Office Check Stub Forms Page 7 of 12 

867-S (6/16) 

LABELING AND MARKING: Reproduce shipping container label from furnished repro, fill in appropriate 

blanks, and attach to shipping containers. 

DEPARTMENTAL RANDOM COPIES (BLUE LABEL): All orders must be divided into equal sub-lots in 

accordance with the chart below. A random copy must be selected from each sub-lot. Do not choose copies from 

the same general area in each sub-lot. The contractor will be required to execute a statement furnished by GPO 

certifying that copies were selected as directed. The random copies constitute a part of the total quantity ordered, 

and no additional charge will be allowed. 

 Check Stub Forms 

 Quantity Number of 

 Ordered Sub-lots 

 500 - 3,200 50 

 3,201 - 10,000 80 

 10,001 - 35,000 125 

 35,001 and over 200 

These randomly selected copies must be packed separately and identified by a special government-furnished blue 

label, affixed to each affected container. The container and its contents shall be recorded separately on all shipping 

documents and sent to: U.S. Government Printing Office, Central Receiving, Attn: Congressional Publishing 

Service (Cathy DeVinney/Lyle Green), 44 H Street, NW, Washington, DC 20401. 

A copy of the print order/specification and a signed Government-furnished certificate of selection, must be included. 

A copy of the Government-furnished certificate must accompany the voucher sent to GPO, Financial Management 

Service, for payment. Failure to furnish the certificate may result in delay in processing the voucher. 

QUALITY ASSURANCE RANDOM COPIES: In addition to the Departmental Random Copies (Blue Label), 

the contractor may be required to submit quality assurance random copies to test for compliance against the 

specifications. The print order will indicate the number required, if any. When ordered, the contractor must divide 

the entire order into equal sub-lots and select a copy from a different general area of each sub-lot. The contractor 

will be required to execute a statement furnished by GPO certifying that copies were selected as directed. Copies 

will be paid for at the running rate offered in the contractor's bid and their cost will not be a consideration for award. 

Business Reply Mail labels will be furnished for mailing the quality assurance random copies. The copies are to be 

mailed at the same time as the first scheduled shipment. A copy of the print order must be included. 

A U.S. Postal Service approved Certificate of Mailing, identified by Program, Jacket and Print Order numbers, must 

be furnished with billing as evidence of mailing. 

DISTRIBUTION: Deliver f.o.b. destination to: U.S. Government Printing Office, Central Receiving, Attn: 

Congressional Publishing Service (Cathy DeVinney/Lyle Green), 44 H Street, NW, Washington, DC 20401. 

Upon completion of each order, all furnished material must be returned to: U.S. Government Printing Office, 

Central Receiving, Attn: Congressional Publishing Service (Cathy DeVinney/Lyle Green), 44 H Street, NW, 

Washington, DC 20401 

All expenses incidental to picking up and returning materials and submitting proofs must be borne by the contractor. 
Senate Disbursing Office Check Stub Forms Page 8 of 12 

867-S (6/16) 

SCHEDULE: Adherence to this schedule must be maintained. Contractor must not start production of any job 

prior to receipt of the individual print order (GPO Form 2511). 

Furnished material and proofs must be delivered to and picked up from: U.S. Government Printing Office, Central 

Receiving, Attn: Congressional Publishing Service (Cathy DeVinney/Lyle Green), 44 H Street, NW, Washington, 

DC 20401. 

No definite schedule for pickup of material can be predetermined. 

The following schedule begins the workday after receipt of notification of availability of print order and furnished 

material; the workday after notification will be the first workday of the schedule. 

Contractor must submit proofs within two (2) workdays of receipt of notification of availability of print order and 

furnished material. 

Proofs will be withheld no more than three (3) workdays from their receipt at the ordering agency until they are 

made available for pickup. (NOTE: The first workday after receipt of proofs at the ordering agency is day one (1) 

of the hold time.) 

Contractor must complete production and distribution within 10 workdays of receipt of “O.K to print” on proofs. 

The ship/deliver date indicated on the print order is the date products ordered for delivery f.o.b. destination must be 

delivered to the destinations specified. 

Unscheduled material such as shipping documents, receipts or instructions, delivery lists, labels, etc., will be 

furnished with each order or shortly thereafter. In the event such information is not received in due time, the 

contractor will not be relieved of any responsibility in meeting the shipping schedule because of failure to request 

such information. 

Contractors are to report information regarding each order for compliance reporting purposes and include date of 

delivery (or shipment if applicable) for proofs and delivery schedules in accordance with the contract requirements 

by contacting Shared Support Services Compliance Section via e-mail to compliance@gpo.gov or by calling (202) 

512-0520 or faxing to (202) 512-1364. Personnel receiving the e-mail or call will be unable to respond to questions 

of a technical nature or transfer any inquiries. 
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867-S (6/16) 

SECTION 3. – DETERMINATION OF AWARD

The Government will determine the lowest bid by applying the prices offered in the “SCHEDULE OF PRICES” to 

the following units of production which are the estimated requirements to produce one (1) year’s production under 

this contract. These units do not constitute, nor are they to be construed as, a guarantee of the volume of work 

which may be ordered for a like period of time. 

The following item designations correspond to those listed in the “SCHEDULE OF PRICES.” 

 (1) (2) 

I. 2 200 
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867-S (6/16) 

THIS PAGE IS INTENTIONALLY LEFT BLANK 
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867-S (6/16) 

SECTION 4. – SCHEDULE OF PRICES

Bids offered are f.o.b. destination. 

Prices must include the cost of all required materials and operations for each item listed in accordance with these 

specifications. 

Bidder must make an entry in each of the spaces provided. Bids submitted with any obliteration, revision, or 

alteration of the order and manner of submitting bids may be declared nonresponsive. 

An entry of NC (No Charge) shall be entered if bidder intends to furnish individual items at no charge to the 

Government. 

Bids submitted with NB (No Bid) or blank spaces for an item may be declared nonresponsive. 

The Contracting Officer reserves the right to reject any offer that contains prices for individual items of production 

(whether or not such items are included in the DETERMINATION OF AWARD) that are inconsistent or unrealistic 

in regard to other prices in the same offer or to GPO prices for the same operation if such action would be in the best 

interest of the Government. 

All invoices submitted to the GPO shall be based on the most economical method of production. 

Fractional parts of 1,000 will be prorated at the per-1,000 rate. 

I. COMPLETE PRODUCT: Prices offered shall include the cost of all required materials and operations 

necessary (including proofs and paper) for the complete production and distribution of the product listed in 

accordance with these specifications. 

 Make-ready Running Per 

 and/or Setup 1,000 Copies 

(1) (2) 

 Per Product .................................................................................................. $___________ $___________ 

_______________ 

(Initials) 
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My production facilities are located within the assumed area of production .................... ________yes ________no 

NOTICE: Bidders OUTSIDE the assumed production area specified on page one of these specifications should 

complete the following information. 

1. Proposed carrier(s) for pickup of Government Furnished Material ___________________________________ 

 a. Number of hours from acceptance of print order to pickup 

 of Government Furnished Material .................................................................. ________________________ 

 b. Number of hours from pickup of Government Furnished Material 

 to delivery at contractor’s plant ....................................................................... ________________________ 

2. Proposed carrier(s) for delivery of completed product _____________________________________________ 

 a. Number of hours from notification to carrier to pickup 

 of completed product ......................................................................................... _______________________ 

b. Number of hours from pickup of completed product to 

 delivery at destination ........................................................................................ _______________________ 

INSTRUCTIONS FOR BID SUBMISSION: Fill out “SECTION 4. – SCHEDULE OF PRICES,” initialing or 

signing each page in the space(s) provided. Submit two copies (original and one exact duplicate) of the 

“SCHEDULE OF PRICES” with two copies of the GPO Form 910, “BID” form. Do not enter bid prices on GPO 

Form 910; prices entered in the “SCHEDULE OF PRICES” will prevail. 

Bidder ____________________________________________________________________________________ 

 _________________________________________________________________________________________ 

(City - State) 

By _______________________________________________________________________________________ 

(Signature and title of person authorized to sign this bid) 

 _________________________________________________________________________________________ 

 (Person to be contacted) (Telephone Number)