Program 573-S

Title: VA Business CardsDepartment: Veterans AffairsDate: Beginning 07.30.12 and ending 09.30.2013

BASIS OF

I COMPLETE PRODUCT AWARD UNIT RATE COST UNIT RATE COST UNIT RATE 

 (a) Printing face only in a single ink color...........per name

(1) Per Box of 250 Cards 15 21.05 315.75 41.00 615.00 19.95 (2) Per Box of 500 Cards 165 24.16 3,986.40 44.00 7,260.00 25.00 

 (b) Thermo (verko) only in a single ink color 

with stamped/embossed seal.....................per name

(1) Per Box of 250 Cards 10 55.78 557.80 64.00 640.00 29.95 (2) Per Box of 500 Cards 110 67.72 7,449.20 68.00 7,480.00 39.50 

CONTRACTOR TOTALS $12,309.15 $15,995.00 

Accelarated Schedule 5.00% $615.46 $799.75 

PREMIUM PAYMENT 5.00% $30.77 20.00% $159.95 25.00% 

SUBTOTAL $12,339.92 $16,154.95 

DISCOUNT 0.00% $0.00 0.00% $0.00 0.00% 

DISCOUNTED TOTALS $12,339.92 $16,154.95 

THERMOQ

Springf

ENVISION PRINT

Wichita, KS

BETTER DEAL ADVERTISING

Phoenix, AZ

Page 1 of 1
Program 573-S Page 1 of 12 

Specifications by MRN 

 U.S. GOVERNMENT PRINTING OFFICE 

 Washington, DC 

 GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

 For the Procurement of 

VA Business Cards 

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

U.S. Department of Veterans Affairs 

 Single Award 

TERM OF CONTRACT: The term of this contract is for the period beginning Date of Award and ending July 31, 

2013, plus up to four (4) optional 12-month extension periods that may be added in accordance with the “OPTION TO 

EXTEND THE TERM OF THE CONTRACT” 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 30, 2012. 

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

Printing Office, Bid Section, Room C-161, Stop: PPSB, 36 H 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. 

THIS IS A NEW PROGRAM. THERE IS NO ABSTRACT AVAILABLE. 

For information of a technical nature, call Roger McKnight at (202) 512-0303. (No collect calls.) 
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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. 8-02)). 

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 Proofs/Average type dimension/Electronic media 

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

P-10. Process Color Match Electronic media 

OPTION TO EXTEND THE TERM OF THE CONTRACT: 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. 
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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). 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 July 31, 2013, 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 April 30, 2012, 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 preaward 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. 

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 July 31, 2013, 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. 
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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. 
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SECTION 2. - SPECIFICATIONS 

SCOPE: These specifications cover the production of business cards requiring such operations as composition, 

electronic prepress, thermographic (verkotype) printing and printing in four-color process, binding, stamping and 

embossing, packing, and distribution. 

TITLE: VA Business Cards. 

FREQUENCY OF ORDERS: Approximately 200 to 300 orders per year. 

QUANTITY: 250 or 500 cards per name per order. 

NOTE: Up to 10 names may be ordered on the same print order; however, the majority of orders placed will be for 

one name only. 

NUMBER OF PAGES: Face only or face and back. 

TRIM SIZE: 3-1/2 x 2”. 

GOVERNMENT TO FURNISH: Electronic media for the static text matter and the agency seal will be furnished at 

the beginning of the contract for use throughout the term of the contract. The furnished electronic media is as 

follows – 

 Platform: Macintosh 10.4 or higher. 

 Storage Media: CD-R; e-mail. 

 Software: QuarkXPress 7.5 or higher; Adobe Illustrator CS2 or higher; Adobe InDesign CS2 or 

higher. 

All platform system and software upgrades (for specified applications) which may occur 

during the term of the contract must be supported by the contractor. 

 Fonts: All printer and screen fonts will be furnished. 

 

 The contractor is cautioned that furnished fonts are the property of the Government and/or 

its originator. All furnished fonts are to be eliminated from the contractor’s archive 

immediately after completion of the contract. 

 Additional 

 Information: A visual of the furnished electronic files with a set of laser proofs may be provided. 

 All graphics and illustrations will be scanned as EPS or TIFF files and furnished in place. 

 Pantone Matching System and CMYK will be used for color identification. 

 GPO Form 952 (Desktop Publishing – Disk Information) will be furnished. 

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., carried in the 

electronic files, must not print on finished product. 

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

FURNISH,” necessary to produce the products in accordance with these specifications. 
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COMPOSITION: Contractor will be required to set up to approximately eight (8) lines of type for each individual’s 

pertinent information, as specified. Each individual’s information will be provided with the print order. 

ELECTRONIC PREPRESS: Prior to image processing, the contractor shall perform a basic check (preflight) of the 

furnished media and publishing files to assure correct output of the required production image. Any errors, media 

damage, or data corruption that might interfere with proper file image processing must be reported to the ordering 

agency, as specified on the print order. 

The contractor shall create or alter any necessary trapping, set proper screen angles and screen frequency, and define 

file output selection for the imaging device being utilized. Furnished files must be imaged as necessary to meet the 

assigned quality level. 

When required by the Government, the contractor shall make minor revisions to the electronic files. It is anticipated 

that the Government will make all major revisions. 

Prior to making revisions, the contractor shall copy the furnished files and make all changes to the copy. 

PROOFS: One (1) Adobe Acrobat (version 7.0 or higher) PDF soft proof. Proof will be transferred to the agency via 

email. The PDF proof will be evaluated for text flow, image position and color breaks. Proofs will not be used for 

color match. 

NOTE: PDF proof must show all text matter and position of seal, if applicable. 

 

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. 

The contractor must not print prior to 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 March 

2011. 

Government Paper Specification Standards No. 12 – http://www.gpo.gov/pdfs/customers/sfas/vol12/vol_12.pdf. 

Color of paper furnished shall be of a uniform shade and a close match by visual inspection of the JCP and/or attached 

color sample(s). The Contracting Officer reserves the right to reject shipments of any order printed on paper the color 

of which, in his opinion, materially differs from that of the color sample(s). 

The paper to be used will be indicated on each print order. 

White and Cream Smooth and Fancy-finish Cover, basis weight: 100 lbs. per 500 sheets, 20 x 26”, equal to JCP Code 

L21. NOTE: Paper must match Cougar Opaque White Cover, Smooth-finish (100-lb.) and Cougar Opaque Natural 

Cover, Smooth-finish (100-lb.), as applicable. 

NOTE: Approximately 90% of all cards ordered will be for the White paper stock. 

PRINTING: Match Pantone number as indicated on the print order. 

Face Only – Print in a single ink color via thermographic (verkotype) printing. Printing consists of text and line 

matter. 

Face and Back – Print in a single ink color via thermographic (verkotype) printing; or, print in four-color process. 

Printing consists of text and line matter. The color of ink may not be the same on both sides. Some orders may 

require a single ink on one side and four-color process on the other side. 
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NOTE: Some cards (for both face only, and face and back) will require a gold stamped and embossed seal. See 

“STAMPING AND EMBOSSING.” 

GPO imprint is waived and must not print on the finished product. 

MARGINS: Margins will be as indicated on the print order or furnished electronic media. 

BINDING: Trim four sides. 

STAMPING AND EMBOSSING: When ordered, contractor must create stamping/embossing media (brass die) 

from furnished copy. 

Stamp and emboss departmental seal in Kurz Hasting’s Gold Imitation Foil (or equal). NOTE: The same agency seal 

will be used on all cards requiring it. 

Approximate stamping area is 3/4” in diameter. 

Stamping must have solid impressions; no picking, pinholes, or filled letters. 

PACKING: Box individual names in units of 250 or 500 cards, as ordered. Affix a copy of each card to the end 

panel of each box for identification. 

Insert box(es) into cushioned shipping bag(s); or, at contractor’s option, into a shipping container. 

If more than one name is ordered on the same print order, the boxes may be packed together if destined for the same 

address. 

Individual boxes, shipping bags, and/or shipping containers must be of sufficient strength as to ensure against damage 

to the product during delivery/shipping and must ensure the package will not open nor split during delivery/shipping. 

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

and attach to shipping containers. 

QUALITY ASSURANCE RANDOM COPIES: 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 sublots and select a copy from a different 

general area of each sublot. 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 GPO program, jacket, and print order numbers 

must be furnished with billing as evidence of mailing. 

DISTRIBUTION: Deliver f.o.b. destination the majority of cards ordered to address(es) in the Washington, DC area. 

(Each package must be marked to the attention of the card individual and their room number.) 

NOTE: The majority of orders placed will require delivery to only one address; however, the delivery address could 

differ for each order. All deliveries must be made via traceable means. 

An occasional order may require the contractor to ship f.o.b. contractor’s city to an address outside the Washington, 

DC area via the VA’s UPS shipping account. VA will provide shipping account information/labels after award. 
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Upon completion of each order, the contractor must notify the ordering agency on the same day that the product 

delivers/ships via email to the address specified on the print order. The subject line of the email shall be “Distribution 

Notice for Jacket XXX-XXX, P.O. XXXXX, Print Order XXXXX.” The notice must provide all applicable tracking 

numbers, shipping method, and title. Contractor must be able to provide copies of all delivery and shipping receipts 

upon agency request. 

Upon completion of the contract, all furnished material and all dies made must be returned to: U.S. Department of 

Veterans Affairs, Attn: Production Manager, Room 736, 810 Vermont Avenue, NW, Washington, DC 20420. 

All expenses incidental to picking up and returning materials, submitting proofs, and furnishing sample copies must be 

borne by the contractor. 

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 must be picked up from and delivered to: U.S. Department of Veterans Affairs, Room 736, 810 

Vermont Avenue, NW, Washington, DC 20420. 

PDF proofs must be emailed to the email address specified on the print order. Emails must be identified by 

program/print order numbers, contractor’s name, and return email address. 

No definite schedule for pickup of material can be predetermined. 

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

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

Regular Schedule –

 Contractor must submit PDF proof within two (2) workdays of notification of availability of print order and 

furnished material. 

 Proofs will be withheld no more than one (1) workday from their receipt at the ordering agency. (The first 

workday after receipt of proofs at the ordering agency is day one (1) of the hold time.) 

NOTE: Agency will notify the contractor with “O.K. to print” or with any changes/corrections via email. 

 Contractor must complete production and distribution within seven (7) workdays of receipt of an “O.K. to 

Print” on proofs. 

Accelerated Schedule – Approximately 5% of all orders placed will require an accelerated schedule as specified 

below. 

 Contractor must submit PDF proof within two (2) workdays of notification of availability of print order and 

furnished material. 

 Proofs will be withheld no more than one (1) workday from their receipt at the ordering agency. (The first 

workday after receipt of proofs at the ordering agency is day one (1) of the hold time.) 

NOTE: Agency will notify the contractor with “O.K. to print” or with any changes/corrections via email. 

 Contractor must complete production and distribution within three (3) workdays of receipt of an “O.K. to 

Print” on proofs. 
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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 destination(s) specified and the date products ordered for shipping f.o.b. contractor’s city must be 

picked up by UPS. 

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

with the 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. 

Upon completion of each order, the contractor is to notify the U.S. Government Printing Office of the date of 

shipment or delivery. Call (202) 512-0516 or 0520; callers outside the Washington, DC area may call toll free 1-800-

424-9470 or 9471. 
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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. 

PREMIUM PAYMENTS: Orders requiring the “Accelerated Schedule” will be paid for at the premium rate in 

accordance with the contractor’s offered percentage in the “SCHEDULE OF PRICES.” 

All other orders will be placed with the “Regular Schedule” and paid for at the basic prices offered. 

Percentages offered for premium priced work are additional to the basic prices offered for units of work. Premium 

payments, when authorized, will apply to all items in the “SCHEDULE OF PRICES.” 

Failure of the contractor to deliver work at the time specified will result in disallowance of premium payments that 

were anticipated and the contractor will not list such items on his billing invoice. 

It is estimated that 5% of the orders placed on this contract will require an accelerated schedule. Premium payments 

for an accelerated schedule will be evaluated for award. Evaluation will be effected by applying the percentage 

increase, offered for the accelerated schedule in the “SCHEDULE OF PRICES,” (Item II.) to all items. 

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

 (1) (2) 

I. (a) 2 4 

 (b) 15 180 

 (c) 5 5 

 (d) 10 15 

 (e) 2 5 

 (f) 2 5 

 
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SECTION 4. - SCHEDULE OF PRICES 

Bids offered are f.o.b. contractor’s city for all shipping outside the Washington, DC area, and f.o.b. destination for all 

other consignments. 

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 non-responsive. 

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 non-responsive. 

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. 

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

necessary (including composition, proofs, stock/paper, and die) for the complete production and distribution of the 

product listed in accordance with these specifications. 

Per Box of Per Box of 

250 Cards 500 Cards

(1) (2) 

 (a) Printing face only in a single ink color............................per name......$___________ $___________ 

 (b) Printing face only in a single ink color 

 with stamped/embossed seal............................................per name......$___________ $___________ 

 (c) Printing face and back in a single ink color ....................per name......$___________ $___________ 

 (d) Printing face and back in a single ink color 

 with stamped/embossed seal on one side ........................per name......$___________ $___________ 

(e) Printing face in a single ink color 

 with stamped/embossed seal and back in 

 four-color process............................................................per name......$___________ $___________ 

 (f) Printing face and back in four-color process...................per name......$___________ $___________ 

_____________ 

(Initials) 
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II. PREMIUM PAYMENTS: Premium payments, when authorized, will apply to all items. Percentage increase 

will be added to all orders which require the “Accelerated Schedule.” 

 Percentage increase..................................................................................................................... __________% 

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)