BID REQUEST FORM/
A201 REQUEST FORM
PM to indicate ______Set Aside Eligible / Project No.
Date
Requisition No.
TO BE COMPLETED BY DESIGNER and sent in MS Word Format to Office of State Procurement
Project Name
Consultant Name / Email
Firm / Date
Firm Address
State Project Manager / Email
Agency / Facility
Project Address / Bldg ID Number
Construction area (sqft)
Tentative bid opening / (submit form minimum of 4 weeks prior to requested date)
Tentative substantial completion date
Estimated construction cost: (Divisions may be combined on small projects with approval of State PM)
Division 1 / General Requirements / $
Division 2 / Existing Conditions / $
Division 3 / Concrete / $
Division 4 / Masonry / $
Division 5 / Metals / $
Division 6 / Wood, Plastics & Composites / $
Division 7 / Thermal & Moisture Protection / $
Division 8 / Openings /Doors,Windows,etc. / $
Division 9 / Finishes / $
Division 10 / Specialties / $
Division 11 / Equipment / $
Division 12 / Furnishings / $
Division 13 / Special Construction / $
Division 14 / Conveying Equipment / $
Division 22, 23, 25 / Plumbing, Mechanical, Automation / $
Division 21 / Fire Protection / $
Division 26, 27 / Electrical and Communications / $
Division 27 / Audio amplificationwith induction systems / $
Division 28 / Electronic Safety and Security / $
Division 31/32 / Earthwork / Exterior Improvements / $
Division 33 / Utilities / $
Other : Div. ______/ ______/ $
OH&P, Bond, Insurance, contingency / $
TOTAL / $
Design/engineering work: _____ to be done thru Contractor _____ none
Building Construction type (per IBC) / ______Occupancy Type ______
Sprinklers for affected construction area: / existing / added in project / none
Number of stories / Fire Protection ______Central ______Local ______none _____
*Project is funded partly or entirely by Omnibus Capital Investment Bill, 2014 Minn. Laws: YES NO (American Steel)
*Project is funded partly or entirely by statebond funds or general fund-financed projects in capital invest bills: YES NO (Jobs Reporting)
*Project is funded partly or entirely by Fund 5400 or 2001 and work will span multiple fiscal years(Multi FY Contract needed) YES NO
*Project includes constructing or renovating a public gathering space YES NO {audio amplification w-induction systems per ANSI Standard)
TO BE COMPLETED BY MMD and returned to State Project Manager
M/E Bid Date (If applicable) / Prime Bid Date
Pre-bid Date ______Diskette, Project Manual & Drawings to MMD by Date ______
_____ / Over $50,000 Preference__ / _____ / Over $150,000 Preference & Subposting
_____ / Over $500,000 TG/ED/VOGoals / _____ / Over $500,000 TG/ED/VO Goals & Subposting
_____ Set-a Side TG/ED/VOsubcontracting goal (Division 00):_____% Completed by:
TO BE COMPLETED BY RISK MANAGEMENT and returned to State Project Manager
Builder’s Risk provided by / State (Use By Owner Paragraph) / Contractor (Use By Contractor Paragraph)
Cost of builder’s risk premium if provided by state / $
Builders Risk not necessary for this project / Other Applicable Insurance
Pollution Liability ______CA9948 Endorsement______MCS 90 Endorsement ______
Professional Liability Design Errors & Omission ______
Aircraft ______Watercraft ______Completed by:
A201 / Special Instructions:
PM’s email a copy of this document to Contract Drafting after the insurance requirement has been established. Please allow 2 days for processing.

c:Acquisition Management Specialist – Materials Management / Marlys Williamson– Risk Management

Bid Request Form Revised 06/26/2017