RFQ Retainer, Part C - Version 1.9 –May 2016
REQUEST FOR QUOTATION DOCUMENT
TO PROVIDE SERVICES ON RETAINER
PART C – FORMS AND NOTICES
Version 1.9
May 2016
LIST OF FORMS
Form 1 Fee Schedule Form
Form 1(A)Offer and Acceptance
Form 2AWork Item Order Form
From 2BWork Item Quote Form
Form 3A Certification – No Conflict of Interest
Form 3BCertification – Conflict of Interest
Form 4List of Service Provider Staff Who Participated in Preparation of the RFQ Submission
Form 5AOccupational Health & Safety Statutory Declaration
Form 5BOccupational Health & Safety: Notice To Service Providers
Form 5COccupational Health & Safety: List of Designated Substances in Ministry Workplaces
Form 6 Check List of Mandatory Documents Required for Quotation
FORM 1: FEE SCHEDULE FORM – HIGHWAY ENGINEERING
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotations for the rates of:
Highway Engineering / Key Individual$ / /hour / For Engineering/Project Management
$ / /hour / For Technical Staff
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
FORM 1: FEE SCHEDULE FORM – BRIDGE ENGINEERING
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Bridge Engineering / Key Individual$ / /hour / For Structural Engineer - Bridge Inspection Work (Professional Engineer)
$ / /hour / For Structural Engineer - Design Work (Professional Engineer)
$ / /hour / For Structural Engineering Work (Technician)
Material Testing (Bridge Deck Condition Survey)
$ / /each test / For (1) Compressive Strength
$ / /each test / For (2) Chloride Content
$ / /each test / For (3) Air Void System
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
FORM 1: FEE SCHEDULE FORM – BRIDGE ENGINEERING
(Continued)
Assignment #: insert number
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
RFQ Retainer, Part C - Version 1.9 – May 2016
FORM 1: FEE SCHEDULE FORM – GEOTECHNICAL ENGINEERING
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Geotechnical / Key Individual$ / /hr / For Professional Engineer/Management
$ / /hr / For Technical Staff
Material Testing
Soil Analysis:
$ / /ea. / For Proctor
$ / /ea. / For Grain Size Analysis - Sieve
$ / /ea. / For Hydrometer
$ / /ea. / For Field Moisture
$ / /ea. / For Atterberg Limits
Asphalt Analysis:
$ / /ea. / For Gradation
$ / /ea. / For Extraction
Investigation:
Boreholes:
$ / /ea. / For Shallow (maximum depth 1.5 m)
$ / /ea. / For Deep (maximum depth 3.0 mm)
Pavement Core Holes (100 mm dia.):
$ / /ea. / For Maximum Depth 200 mm
$ / /ea. / For Maximum Depth 400 mm
$ / /ea. / For Hand Auger Holes
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
FORM 1: FEE SCHEDULE FORM – GEOTECHNICAL ENGINEERING
(Continued)
Assignment #:insert number
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
RFQ Retainer, Part C - Version 1.9 – May 2016
FORM 1: FEE SCHEDULE FORM – FOUNDATION ENGINEERING
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Foundations - Geotechnical / Key Individual$ / /hour / For Investigation Phase
$ / /hour / For Design Phase
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.)
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
RFQ Retainer, Part C - Version 1.9 – May 2016
FORM 1: FEE SCHEDULE FORM – FISHERIES SERVICES AND AQUATIC ECOSYSTEM SERVICES
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Rate / Rate / Unit / Fisheries and Aquatic Ecosystem Services / Key Individual$ / For Project Manager
$ / For Fisheries Biologist - Senior
$ / For Fisheries Biologist - Intermediate
$ / For Fisheries Biologist - Junior
$ / For Wildlife Biologist - Senior
$ / For Wildlife Biologist - Intermediate
$ / For Wildlife Biologist - Junior
$ / For Terrestrial Biologist - Senior
$ / For Terrestrial Biologist - Intermediate
$ / For Terrestrial Biologist - Junior
$ / For Fluvial Geomorphologist
$ / For Technician
$ / For CAD/GIS Technician
$ / For Equipment Rental (specify type)
$ / For Support Staff
$ / Other
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
FORM 1: FEE SCHEDULE FORM – FISHERIES SERVICES AND AQUATIC ECOSYSTEM SERVICES
(Continued)
Assignment #: insert number
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
FORM 1: FEE SCHEDULE FORM – ELECTRICAL ENGINEERING
(Also Includes Requirements for Traffic Engineer)
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotations for the rates of:
Electrical Engineering / Key Individual$ / /hour / For a Project Manager
$ / /hour / For a Traffic Engineer
$ / /hour / For an Electrical Designer
$ / /hour / For an Electrical Quality Control
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
FORM 1: FEE SCHEDULE FORM – ELECTRICAL ENGINEERING
(Also Includes Requirements for Traffic Engineer)
(Continued)
Assignment #: insert number
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
RFQ Retainer, Part C - Version 1.9 – May 2016
FORM 1: FEE SCHEDULE FORM – ARCHAEOLOGICAL SERVICES
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Assessment (includes expenses and report) / Key Individual$ / /hr / For Project Manager
$ / /hr / For Field archaeologist
$ / /hr / For Field/Lab Technician
$ / /hr / For Support Staff
$ / Sundry Expenses
$ / /hr / For Aboriginal Monitor (Stage 3 and 4 work only)
$ / /hr / For Contract Ploughing
$ / /hr / For Heavy equipment Rental
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFQ to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates quoted are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
FORM 1: FEE SCHEDULE FORM – ARCHAEOLOGICAL SERVICES
(Continued)
Assignment #: insert number
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
RFQ Retainer, Part C - Version 1.9 – May 2016
FORM 1:FEE SCHEDULE – BUILT HERITAGE SERVICES
Agreement #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM: The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Cost / Rate Unit (/day or /hour as applicable / Task or Activity / Key Individual$ / /hr / For Project Manager
$ / /hr / For Background/Historical Research
$ / /hr / For Field Supervisor
$ / /hr / For Field Technician
$ / /hr / For Technical Staff
$ / /hr / For CAD/Mapping/Cartography Services
$ / /hr / For Researcher
The Service Provider agrees that upon acceptance of this Tender by the Ministry, this Tender, the RFP to which this Tender is attached, the successful Service Provider's Quotation and the Retainer Services Legal Agreement shall form a legally binding agreement.
The rates Proposed are to be inclusive of all operating costs and disbursements (supplies, equipment, vehicles, fuel, travel, meals, etc.).
The total price should not include HST.
Canada and Ontario have entered into a Comprehensive Integrated Tax Coordination Agreement whereby Ontario has agreed to pay harmonized sales tax (HST) on its purchases. For Deliverables provided on or after July 1, 2010, the supplier shall invoice and collect HST from the Ministry for the Deliverables in accordance with the provisions of the Excise Tax Act, R.S.C. 1985, c.E-15, as amended or replaced from time to time.
FORM 1:FEE SCHEDULE – BUILT HERITAGE SERVICES
(Continued)
Agreement #: insert number
This Tender shall be irrevocable and open for acceptance for a period of ninety (90) calendar days following the Quotation Due Date.
I HAVE AUTHORITY TO BIND THE SERVICE PROVIDER:
______
Name of SignatoryDate
(Key Contact/Alternate Contact in RAQS)
______
Signature
______
Title Service Provider Firm Name
FORM 1: FEE SCHEDULE FORM – WASTE MANAGEMENT SERVICES
Assignment #: insert number
TO:Her Majesty the Queen in right of Ontario as represented by the Ministry of Transportation (the “Ministry”).
FROM:The Service Provider
ADDRESS:
TENDER
The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified in the Legal Agreement and this Request for Quotation for the rates of:
Environmental – Waste Management / Key Individual$ / For Project Manager / Engineer
$ / For Senior Professional / Technical Staff
$ / For Technical Staff
$ / For Geophysical Survey1
$ / For Backhoe/Excavator Services (including Mobilization/ Demobilization)
$ / For Drill Rig Services (including Mobilization/Demobilization)
$ / /hr / For Track Mount Drill Rig (including Mobilization/Demobilization)
$ / /well / For Monitoring Well Materials
$ / /day / For Surveying Equipment
$ / /day / For Gastechtor and Other Meter Rental
$ / /day / Monitoring Well Record Reporting
$ / /day / For Regulatory Request Fees
$ / /day / For Regulatory Request Fees
$ / /day / For Regulatory Request Fees
FORM 1: FEE SCHEDULE FORM – WASTE MANAGEMENT SERVICES
(continued)
Assignment #: insert number
Environmental – Waste Management - Laboratory Services –N/AParameter / Unit Rates / Sample / Name of Laboratory
SOIL
BTEX / $
F1 to F4 Hydrocarbons / $
PAH / $
PCB / $
VOC Scan / $
Metals (including Pb and Hg) / $
TCLP (for VOC) / $
TCLP (full scan) / $
WATER
BTEX / $
F1 to F4 Hydrocarbons / $
Anion/Cation Scan2 / $
General Chemistry3 / $
PAH / $
PCB / $
VOC Scan / $
Metals (including Pb and Hg) / $
OTHER
Asbestos / $
Lead / $
Notes: