ATTACHMENT B

SAMPLE PROPOSAL LETTER

Date: _____________

David Melko, Senior Transportation PlannerPlacer County Transportation Planning Agency 299 Nevada Street, Auburn, CA 95603

Re: Placer County Freeway Service Patrol Request for Proposal, September 5, 2014

Dear Mr. Melko:

In response to the Request for Proposal ("RFP"), for the Placer County Freeway Service Patrol, we the undersigned hereby declare that we have carefully read and examined the RFP documents including any plans and specifications, acknowledge receipt of any and all Addenda, understand that any questions with regard to this proposal must occur in writing by September ___, 2014 (see Item 15.0). We hereby propose to perform and complete the work as required.

Addenda No.: ______________________________________

If the proposal is accepted within 120 days from the date specified in the RFP for receipt of proposals, the undersigned agrees to make available the services at the costs indicated on its Bid Submittal Form (Attachment B).

If awarded a Contract, the undersigned agrees to execute a formal Task Agreement and Master Agreement as set forth in Attachment C, within 30 calendar days following PCTPA acceptance of proposal, and will deliver to PCTPA prior to execution of the Contract the necessary original Certificates of Insurance.

If the Proposer requests any changes to this Contract Agreement language, such requests must be included within this letter or it shall be understood that the Proposer accepts the terms and conditions contained in Attachment C of the RFP in its entirety.

Proposer represents that the following person(s) are authorized to negotiate on its behalf with PCTPA in connection with this RFP:

(Name)______________________ (Title) _______________ (Phone) _______________

(Name)______________________ (Title) _______________ (Phone) _______________

(Name)______________________ (Title) _______________ (Phone) _______________

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The undersigned certifies that it has examined and is fully familiar with all of the provisions of the RFP. The undersigned hereby agrees that PCTPA will not be responsible for any errors or omissions in the RFP.

The undersigned further certifies he/she is satisfied that their proposal is accurate; that it has carefully checked all the words and figures and all statements made in their proposal; that it has satisfied itself with respect to other matters pertaining to their proposal, which in any way affect the work or the cost thereof.

Proposer's Business Addressand Telephone/Fax Numbers & Email:

BY: _____________________________ ____________________________ (Signature)

_____________________________ ____________________________(Type or Print Name)

_____________________________ ____________________________(Title)

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ATTACHMENT B

CONTRACTOR REPRESENTATIVE FORM

CONTRACTOR NAME: _________________________________________________

PRINCIPAL: ___________________________________________________________ (Print)

_____________________________________ _______________________ (Signature) (Date)

ALTERNATE NO. 1

_________________________________________________________

ALTERNATE NO. 2

_________________________________________________________

ALTERNATE NO. 3

_________________________________________________________

The above named individuals have read and understand the Freeway Service Patrol contract. At least one of these individuals will be available at the Contractor's office during Freeway Service Patrol hours of operation and normal business hours to make operational decisions on behalf of the Contractor pursuant to the terms and conditions of the contract.

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ATTACHMENT B

BID SUBMITTAL FORM

CONTRACTOR NAME:

TITLE:

COMPANY:

ADDRESS:

TELEPHONE#:

BUSINESS LICENSE #:

OR TAX CERTIFICATE AND TOW OPERATOR PERMIT #'S:

LICENSE CLASSIFICATION:

PROPOSAL:

Proposal should take into consideration all vehicles, tools and equipment, operating cost, insurance, mandatory training classes, personnel, tools, fuel (for motorists as well as operating vehicles), uniforms, supplies, expendable items, incidentals, overhead, etc. Please refer to the Scope of Services to ensure that all possible costs are covered in the proposal.

TOTAL # OF TOW/SERVICE TRUCKS: ______________

COST PER HOUR PER TOW TRUCK: $_____________

COST PER HOUR PER SERVICE TRUCK: $_____________

TOTAL COST PER HOUR FOR THIS PROPOSAL: $_____________

AUTHORIZED SIGNATURE: __________________________________

DATE: ___________________

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ATTACHMENT B

QUESTIONNAIRE

CONTRACTOR NAME: _________________________________________________

This form must be completed by owner or authorized representative. The purpose of this form is to ensure that you are aware of all costs of Freeway Service Patrol service and to simplify the selection panel's review of your proposal. All questions must be answered. (DO NOT SIMPLY SAY “REFER TO RFP PAGE #xx). Proposer may attach additional pages to answer questions if necessary.

UNDERSTANDING OF CONTRACT TERMS

1. Owner’s number of years of tow truck operations (5 years minimum):

Years as owner: ____________ Years in towing business: ___________________________

Years in CHP Rotation Tow: ____________ Years in AAA Tow

Current number of tow trucks operated: __________________________________________

2. FSP beat operating hours: _____________________________________________________

3. Describe activities prohibited by FSP Contractors:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Describe FSP Contractor duties on a daily basis:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. How frequently will your trucks be inspected by CHP?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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6. What tests must an FSP operator pass before operating in FSP Service?

A.____________________________________________________________________

B.___________________________________________________________________

C.____________________________________________________________________

7. What does an FSP operator wear?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. What equipment is found on an FSP tow truck? (Attach separate list)

9. What are the FSP insurance requirements you must meet?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

10. When is the last day to submit questions?

11. What do perspective FSP Contractors need to do to receive answers to questions received and by what date must they do it?

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. How many trucks (including back-up trucks) and operator must you have for this beat? Attach a list of trucks that will be used for the FSP service. Include the year, manufacturer, model, current mileage and vehicle identification number (VIN). (See RFP Section 1.4, Equipment Requirements). If a Proposer does not own the required number of trucks for the FSP beat, a statement as to how the new trucks will be required and the timeline for acquisition must be provided with the list of trucks.

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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ATTACHMENT B

BUSINESS, FINANCIAL, AND TOWING SERVICE REFERENCES

CONTRACTOR NAME: _________________________________________________

Attach letters of reference here from individuals, financial institutions, creditors, towing services, law enforcement agencies, service clubs, etc., who are keenly aware of Proposer’s experience and capabilities with regard to business practices, financial stability, and towing services provided. Do not attach references from relatives.

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ATTACHMENT B

WORK PLAN DESCRIPTION

CONTRACTOR NAME: _________________________________________________

Please define below or in a separate attachment a description of the work required to fulfill the Scope of Services. Proposer should refine and/or expand the Scope of Services in the RFP to reflect the particular plan they would use to implement the program. Proposer shall address any problems that he/she envisions to be associated with the work and provide specific suggestions for avoiding these problems.

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ATTACHMENT B

CONTRACTOR PROPOSED VEHICLE LIST

CONTRACTOR NAME: _________________________________________________

Each proposal shall include the year, manufacturer, model, current mileage, and vehicle identification (VIN) of each truck that used in the Placer County FSP program. This information should be entered on the table, “Proposed Vehicle List.” If the Proposer does not currently own the vehicles, but plans to acquire the vehicles, a statement as to how these vehicles will be acquired and the timeline for acquisition shall be provided.

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ATTACHMENT B

CONTRACTOR PROPOSED VEHICLE LIST

YEAR MANUFACTURER MODEL CURRENT MILEAGE

VEHICLEIDENTIFICATION

NUMBER (VIN)GVWR

CURRENTLYOWNED?YES/NO*

*If vehicle is not currently owned by Proposer, please attach additional sheets as necessary to explain vehicle procurement plan.

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EXHIBIT 10-O1: LOCAL AGENCY CONSULTANT DBE COMMITMENT(Inclusive of all DBEs at time of proposal)

NOTE: Please refer to instructions on the reverse side of this form.Consultant to Complete this Section

1. Local Agency Name: ________________________________________________________________________________________

2. Project Location: ___________________________________________________________________________________________

3. Project Description: _________________________________________________________________________________________ 4. Consultant Name: __________________________________________________________________________________________

5. Contract DBE Goal %: ________________

DBE Commitment Information6. Description of Services to be Provided 7. DBE Firm

Contact Information8. DBE Cert.

Number9. DBE %

Local Agency to Complete this Section

16. Local Agency Contract Number: ________________________________________________

17. Federal-aid Project Number: ___________________________________________________

18. Proposed Contract Execution Date: ________________________

Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate:

_____________________________________________________________________________ 19. Local Agency Representative Name (Print)

___________________________________________________ ________________________ 20. Local Agency Representative Signature 21. Date ___________________________________________________ ________________________ 22. Local Agency Representative Title 23. (Area Code) Tel. No.

10. Total % Claimed

___________ %

________________________________11. Preparer’s Signature

________________________________

12. Preparer’s Name (Print)

________________________________ 13. Preparer’s Title

____________ ___________________14. Date 15. (Area Code) Tel. No.

Distribution: (1) Original – Submit with Award Package(2) Copy – Local Agency files

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INSTRUCTIONS - LOCAL AGENCY CONSULTANT DBE COMMITMENT

Consultant SectionThe Consultant shall:

1. Local Agency Name – Enter the name of the local or regional agency that is funding the contract.2. Project Location - Enter the project location as it appears on the project advertisement.3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab,

Overlay, Widening, etc).. 4. Consultant Name - Enter the consultant’s firm name.5. Contract DBE Goal % - Enter the contract DBE goal percentage, as it was reported on the Exhibit 10-I form. See LAPM

Chapter 10.6. Description of Services to be Provided - Enter item of work description of services to be provided. Indicate all work to be

performed by DBEs including work performed by the prime consultant’s own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms.

7. DBE Firm Contact Information - Enter the name and telephone number of all DBE subcontracted consultants. Also, enter the prime consultant’s name and telephone number, if the prime is a DBE.

8. DBE Cert. Number - Enter the DBEs Certification Identification Number. All DBEs must be certified on the date bids are opened. (DBE subcontracted consultants should notify the prime consultant in writing with the date of the decertification if their status should change during the course of the contract.)

9. DBE % - Percent participation of work to be performed or service provided by a DBE. Include the prime consultant if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation.

10. Total % Claimed – Enter the total participation claimed. If the Total % Claimed is less than item “6. Contract DBE Goal”, a Good Faith Effort (GFE) is required.

11. Preparer’s Signature – The person completing this section of the form for the consultant’s firm must sign their name.12. Preparer’s Name (Print) – Clearly enter the name of the person signing this section of the form for the consultant.13. Preparer’s Title - Enter the position/title of the person signing this section of the form for the consultant.14. Date - Enter the date this section of the form is signed by the preparer.15. (Area Code) Tel. No. - Enter the area code and telephone number of the person signing this section of the form for the

consultant.

Local Agency Section:

The Local Agency representative shall:16. Local Agency Contract Number - Enter the Local Agency Contract Number. 17. Federal-Aid Project Number - Enter the Federal-Aid Project Number.18. Contract Execution Date - Enter the date the contract was executed and Notice to Proceed issued. See LAPM Chapter 10, page

23.19. Local Agency Representative Name (Print) - Clearly enter the name of the person completing this section.20. Local Agency Representative Signature - The person completing this section of the form for the Local Agency must sign their

name to certify that the information in this and the Consultant Section of this form is complete and accurate.21. Date - Enter the date the Local Agency Representative signs the form. 22. Local Agency Representative Title - Enter the position/title of the person signing this section of the form.23. (Area Code) Tel. No. - Enter the area code and telephone number of the Local Agency representative signing this section of the

form.

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Exhibit 10-O2: Local Agency Consultant DBE Information(Inclusive of all DBEs listed at bid proposal)

NOTE: Please refer to instructions on the reverse side of this form.Consultant to Complete this Section

1. Local Agency Name: ________________________________________________________________________________________

2. Project Location: ___________________________________________________________________________________________

3. Project Description: _________________________________________________________________________________________

4. Total Contract Award Amount: $ ______________________

5. Consultant Name: __________________________________________________________________________________________

6. Contract DBE Goal %: ________________

7. Total Dollar Amount for all Subcontractors: $ ______________________

8. Total Number of all Subcontractors: _______________

Award DBE Information9. Description of Services to be Provided 10. DBE Firm

Contact Information11. DBE Cert.

Number12. DBE Dollar

Amount

Local Agency to Complete this Section

20. Local Agency Contract Number: ________________________________________________

21. Federal-aid Project Number: ___________________________________________________

22. Contract Execution Date: ________________________

Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate:

_____________________________________________________________________________ 23. Local Agency Representative Name (Print)

___________________________________________________ ________________________ 24. Local Agency Representative Signature 25. Date ___________________________________________________ ________________________ 26. Local Agency Representative Title 27. (Area Code) Tel. No.

13. Total Dollars Claimed $ ___________

14. Total % Claimed

___________ %

________________________________15. Preparer’s Signature

________________________________

16. Preparer’s Name (Print)

________________________________ 17. Preparer’s Title

____________ ___________________18. Date 19. (Area Code) Tel. No.

Caltrans to Complete this Section Caltrans District Local Assistance Engineer (DLAE) certifies that this form has been reviewed for completeness:

___________________________ _______________________________ ______________ 28. DLAE Name (Print) 29. DLAE Signature 30. Date

Distribution: (1) Copy – Email a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract award. Failure to send a copy to the DLAE within 30 days of contract award may result in delay of payment.

(2) Copy – Include in award package sent to Caltrans DLAE (3) Original – Local agency files

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INSTRUCTIONS - LOCAL AGENCY CONSULTANT DBE INFORMATIONConsultant SectionThe Consultant shall:

1. Local Agency Name – Enter the name of the local or regional agency that is funding the contract.2. Project Location - Enter the project location as it appears on the project advertisement.3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic

Rehab, Overlay, Widening, etc).4. Total Contract Award Amount - Enter the total contract award dollar amount for the prime consultant. 5. Consultant Name - Enter the consultant’s firm name.6. Contract DBE Goal % - Enter the contract DBE goal percentage, as it was reported on the Exhibit 10-I form. See

LAPM Chapter 10.7. Total Dollar Amount for all Subcontractors – Enter the total dollar amount for all subcontracted consultants. SUM =

(DBE’s + all Non-DBE’s). Do not include the prime consultant information in this count.8. Total number of all subcontractors – Enter the total number of all subcontracted consultants. SUM = (DBE’s + all

Non-DBE’s). Do not include the prime consultant information in this count.9. Description of Services to be Provided - Enter item of work description of services to be provided. Indicate all work

to be performed by DBEs including work performed by the prime consultant’s own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms.

10. DBE Firm Contact Information - Enter the name and telephone number of all DBE subcontracted consultants. Also, enter the prime consultant’s name and telephone number, if the prime is a DBE.

11. DBE Cert. Number - Enter the DBE’s Certification Identification Number. All DBEs must be certified on the date bids are opened. (DBE subcontracted consultants should notify the prime consultant in writing with the date of the decertification if their status should change during the course of the contract.)

12. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime consultant if the prime is a DBE, and include DBEs that are not identified as subcontractors on the Exhibit 10-O1 form. See LAPM Chapter 9 for how to count full/partial participation.

13. Total Dollars Claimed – Enter the total dollar amounts for columns 12 and 13.14. Total % Claimed – Enter the total participation claimed for columns 12 and 13. SUM = (item “14. Total Participation

Dollars Claimed” divided by item “4. Total Contract Award Amount”). If the Total % Claimed is less than item “6. Contract DBE Goal”, a Good Faith Effort (GFE) is required.

15. Preparer’s Signature – The person completing this section of the form for the consultant’s firm must sign their name.16. Preparer’s Name (Print) – Clearly enter the name of the person signing this section of the form for the consultant.17. Preparer’s Title - Enter the position/title of the person signing this section of the form for the consultant.18. Date - Enter the date this section of the form is signed by the preparer.19. (Area Code) Tel. No. - Enter the area code and telephone number of the person signing this section of the form for the

consultant.

Local Agency Section:

The Local Agency representative shall:20. Local Agency Contract Number - Enter the Local Agency Contract Number. 21. Federal-Aid Project Number - Enter the Federal-Aid Project Number.22. Contract Execution Date - Enter the date the contract was executed and Notice to Proceed issued. See LAPM Chapter

10, page 23.23. Local Agency Representative Name (Print) - Clearly enter the name of the person completing this section.24. Local Agency Representative Signature - The person completing this section of the form for the Local Agency must

sign their name to certify that the information in this and the Consultant Section of this form is complete and accurate.25. Date - Enter the date the Local Agency Representative signs the form. 26. Local Agency Representative Title - Enter the position/title of the person signing this section of the form.27. (Area Code) Tel. No. - Enter the area code and telephone number of the Local Agency representative signing this

section of the form.

Caltrans Section:

Caltrans District Local Assistance Engineer (DLAE) shall:28. DLAE Name (Print) – Clearly enter the name of the DLAE.29. DLAE Signature – DLAE must sign this section of the form to certify that it has been reviewed for completeness.30. Date - Enter the date that the DLAE signs this section the form.

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