STATE OF CALIFORNIA ATTACHMENT B
DEPARTMENT OF GENERAL SERVICES
OFFICEOFFLEETANDASSETMANAGEMENT
VENDORAPPLICATIONFORM
OFA 50 (Rev 09/14)
ThisVendorApplicationFormisdesignedtoensurethatallvendorsprovidetherequestedinformationinordertobeauthorizedtoprovide automotive repair/servicesforstateagencies.
- BusinessName: DBA,ifapplicable: Address:. City: County: State: ;ZipCode:. Telephone:. FAX:
Email Address: ______
Amount of time company has been in business providing automotive repair/services:____years______months
- Typesofvehiclesserviced:Light duty [ ]Heavy duty [ ]Specialty [ ]
- Name of flat rate manual______
- Hourly public flat rate______
- Hourly fleet flat rate______
- Parts, fleet discount______%
- Pickup/delivery at no chargeYes [ ] No [ ]
Checktypeofrepair/serviceprovided. CheckwheretechniciansareASEcertified.
Repair/ServiceASECertifiedRepair/ServiceASECertified
[ ]A[ ]Engine performance/drivability[ ]J[ ]Manual drive train and axles
[ ]B[ ]Minor engine repair[ ]K[ ]Smog Check
[ ]C[ ]Brakes[ ] L[ ]Auto body repair/paint
[ ]D[ ]Electrical/electronic systems[ ]M[ ]Glass
[ ]E[ ]Major engine repair (gasoline)[ ]N[ ]Mobile services
[ ]F[ ]Major engine repair (diesel)[ ]O[ ]Tires
[ ]G[ ]Heating/cooling and air conditioning[ ]P[ ]Towing
[ ]H[ ]Suspension and steering[ ]Q[ ]Upholstery
[ ]I[ ]Automatic transmission/transaxle[ ]R[ ]Specialty
(window tinting, alarms, etc)
AttachcopiesofcurrentASEcertificates.
PrintedNameSignatureofAuthorizedRepresentative
Title:_Date._
By signing this form, I/we agree that we have met all requirements contained in RFQ DGS-OFA-VQ-1, and agree that when services are rendered to state agencies those services will be rendered pursuant to the requirements of RFQ DGS-OFA-VQ-1.
Checkhereifyourfacilityhasthefollowingequipment:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
GENERALEQUIPMENT
lIHoist/lift/rack; Lubricationequipment;Partswasher;Safetystands;Servicemanualsorelectronic accesstoinformation;Torquewrenches(in./lb.ft./lb.); Weldingequipment;Verniercaliperor0-4" micrometer
ENGINEPERFORMANCEIDRIVEABILITY(GAS)
[ICompressiontester;Vacuumpump;Engineanalyzerwithdisplaycapabilityorequivalent;Timinglight; Exhaustgasanalyzer;Dwellmeter;Tachometer;Fuelinjectionpressuretester;Injectorpulsetester;
Computercodescanner;Cylinderleaktester.
ENGINEPERFORMANCEIDRIVEABILITY(DIESEL)
lIDieseltachometer;Dieselcompressiongauge;Nozzletester;Pumptimingtools
EXTERNALENGINEREPAIRIPARTSREPLACEMENT (Includescylinderheads)
[IHandheldtools.
BRAKES
[IBrakedrumgauge;Brakediscmicrometer;Dialindicator;Pressurebleeder.
ELECTRICAL
[IDigitalvolt/ohmmeter;Batteryloadtester;Batterycharger;Starting/chargingsystemtester.
TIRES,STEERINGANDSUSPENSION
[IAlignmentrack/tables*;Wheelbalancer*; Coilspringcompressor;Tirechanger*;Toolsfordisassembly
andassemblyofsteeringjoints.
HEATINGICOOLINGANDAIRCONDITIONING
lIRadiatorandcappressuretester;Airconditioningmanifoldgauge set;Freonrecovery/recycling equipment;Antifreezerecyclingequipment;Coolingsystemthermometer;Airconditioningthermometer.
AUTOMATICTRANSMISSION
[I300PSIpressuregauge;30inchhg.vacuumgauge;Transmissionjacl<;Bushingcutter;Bushingand
sealdriverset;Sealpuller; varioussnapringpliers;Hydraulic press.
MANUALTRANSMISSIONANDREARAXLE
lIAxlepuller;Hydraulicpress*;Clutchaligningtools.
MAJORENGINEREPAIR(GASORDIESEL) Enginereplacement:
[IEnginerepairstand;Enginecrane/hoist;Pullerset.
Enginerebuilding:
[IValverefacerandseatcutter*;Cylinderhone;Cylinderboregauge; 0-4"micrometer.
CheckhereIfyourfacilityusesthefollowingproducts:
13.[IRecycledoil
14. [JRecycledantifreeze
*Not required if service is sublet.
OFA 50, page 2