Firm (Name and Address) Work, Material or Service (Provide Brief Description) Supplier Diversity/SEED Program Status Percent (%) (Of Total Proposal Price) Dollar Amount (Of This Firm's Work, Material or Service) 1. PROPOSER/PRIME CONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal 2. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal 3. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal 4. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal DESIGNATION OF PRIME CONTRACTOR, SUBCONTRACTORS, AND SUPPLIERS (Continuation Page ; may be duplicated as needed) SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal
SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification DIR # SEED Qualified Yes No ___ % of Total Proposal $_________ Amount of Total Proposal CONTRACTOR’S LICENSE INFORMATION I, hereby certify under penalty of perjury, that (Print Company Representative Name) is/are (Print Company Name) licensed by the California Department of Consumer Affairs, Contractors State License Board, under Chapter 9 of Division 3 of the Business and Professions Code of the State of ; and that said license(s) is/are in a classification(s) appropriate for the work to be undertaken. It is the responsibility of the Contractor to verify that all of its subcontractors have a California Contractor’s License that is active, current and in good standing.
1 (SC-3.1, TC12-16, TC20 - 22) Supply, test, and deliver Main Line Valve #9 (inclusive of all costs) 1 LS $ 1.1 (SC-3.2, Ground Water Wells and Monitoring (inclusive of all costs) 1 LS $ 1.2 (SC-3.3, Ground Water Pumping (inclusive of all costs for 4 weeks) 1 LS $ 1.3 (SC-3.4, TC11) Supply and Install Natural Gas Monitoring Tap (inclusive of all costs for both) 1 LS $ 1.4 (SC-3.5, TC23-26) Install Main Line Valve #9 (inclusive of all costs) 1 LS $ 1.5 (SC-3.6, TC25) Pipeline purging (inclusive of all costs) 1 LS $ 1.6 (SC-3.7, TC21,23,26) Commission Main Line Valve #9 (inclusive of all costs) 1 LS $ Main Line Valve #2 2 (SC-3.1, TC12-16, TC20 - 22) Supply, test, deliver, and commission Main Line Valve #2 (inclusive of all costs) 1 LS $ 2.1 (SC-3.7, TC21,23,26) Commission Main Line Valve #9 (inclusive of all costs) 1 LS $ 3 (TC-27) Training (inclusive of all costs) 1 LS $ 4. Additional SMUD Directed Work (See SC-14) Cost/Unit Est. Qty Total 4.1 Ground Water Pumping (inclusive of all costs) $ /Week 4 Weeks $ 4.2 Hydrovac Excavation (inclusive of all costs) $ /Cu. Yd. 8 Cu. Yds. $ 4.3 Thrust block demolition (inclusive of all costs) $ /Cu. Yd. 5 Cu. Yds. $ Est. Qty. Multiplier Total 4.4 Prime and Subcontract Craft Labor, All Trades, Straight Time $12,000 1. $