BID FORM. 1. The Undersigned (check one of the following and insert information as requested):

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BID FORM

PROJECT: West Loop Medium Voltage Testing & Maintenance (MVT&M) RFP #1565 BID DEADLINE: October 12, 2015 3:00 PM Local Time

FROM: __________________________________________________________________ Name of Contractor

TO: Portland State University, Contracting and Procurement Services.

1. The Undersigned (check one of the following and insert information as requested):

____a. An individual doing business under an assumed name registered under the laws of the State of _____________________________; or

____b. A partnership registered under the laws of the State of _____________________; or ____c. A corporation organized under the laws of the State of ____________________; or ____d. A limited liability corporation/company organized under the laws

of the State of _____________________________;

hereby proposes to furnish all material and labor and perform all Work hereinafter indicated for the above

project in strict accordance with the Contract Documents for the Base bid as follows:

___________________________________________________________________ Dollars ($__________________) and the Undersigned agrees to be bound by each of the following documents:

• Advertisement for Bids or Notice of Public Improvement Contract Opportunity • Instructions to Bidders

• Supplemental Instructions to Bidders, if any • Sample Public Improvement Agreement • PSU General Conditions, July 1, 2014 • Supplemental General Conditions, if any • Plans and Specifications

• Drawings and Details • Prevailing Wage Rates

• Payroll and Certified Statement Form

• Any ADDENDA numbered ____ through____, inclusive (fill in blanks).

2. The Undersigned proposes to add to the Base Bid indicated above the items of work relating to the following Alternate(s) as designated in the scope of work:

ALTERNATE #1: Prepare a proposed line item list for each item listed below. Refer to scope below and the one-line diagram in Appendix 4.12:

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PSU BID FORM Page 2 of 4 Scope: Provide seismic bracing calculations performed by an Oregon registered structural engineer and install the specific anchoring devices as recommended by structural engineer. Each switchboard needs to be visually assessed to verify if proper anchoring is present. Contractor to bid as if no anchoring is present. If it is determined that anchoring is present, complies with current seismic calculations and recommendations, contractor to issue a credit to PSU. If proper anchoring is not present, the switchboard needs to be anchored externally without shutting down the switchboard. If shutting down the switchboard is required then notify PSU CPC. Provide additive cost line item per building at the time of bid to provide mobilization, connection and demobilization for stand-by generators to perform the work as indicated.

CHNW-A BID NH1-B BID SRTC-A BID CHSE-B BID LBE-A BID SRTC-C BID CHSE-C BID SB1-A BID XSB-A BID NH-A BID SMSU-A BID WHP-B BID ADD COST: $_______________

ALTERNATE #2: Prepare a proposed line item for each item listed below. Refer to scope below and the one-line diagram in Appendix 4.12.

Scope: Provide quantities and types of fuses listed below. Field verify fuses provided match to the existing ones that are currently installed. Spare fuses to be located in close proximity of associated switchboard.

SB1-B BID (3) SM-4 SLOW : 20E, (3) STD: 65E, (3) SM-4 SLOW: 60E WHP-C BID (3) SM-4 STD: 10E, (3) SM-4 SLOW: 100E

CHNW-D BID (3) SM-4: 40E, (3) SM-4: 60E, (3) SM-4: 80E

CHSE-E/F BID (3) SM-5: 75E, (3) SM-5: 65E, (3) SM-5: 25E, (3) SM-4: ??E (3) SM-4: 125E, (3) SM-5: 100E, (3)EJ-01, (3) SM-4: 200E NH-C BID (3) STD: 65E

NH1-D BID (3) STD: 65E, (3) SM-4 SLOW: 20E, (3) SM-4 SLOW: 80E SMSU-B BID (3) SM-4 STD: 50E, (3) SM-4 SLOW: 50E, (3) SM-4 STD: 40E SRTC-B BID (3) SM-5: 175E, (3) SM-5: 65E, (3) SM-5: 80E, (3) SM-5: 80E SRTC-D BID (9) SM-5 SLOW: 300E, (9) SLOW: 200E, (6) SM-5 SLOW: 150E XSB-B BID (3) SM-4 STD: 15E

LBE-E BID (3) SM-4 STD: 40E ADD COST: $_______________

ALTERNATE #3: Prepare a proposed plan which includes a conceptual design, logistics and construction line item for the listed item below. Refer to scope below and the one-line diagram in Appendix 4.12.

Scope: Provide generator docking station and termination for Switchboard “SRTC-SWBD1”. Include routing, permitting, stand by permanent conductors and raceway and integration into existing distribution system. Station to be rated for voltage of switchboard and 75% of rated amperage of OCPD. Station to be located exterior to the building in an accessible location for stand-by temporary generation. Include any required mobilization, shutdown, usage, demobilization and labor to perform the installation. Station to include industry safety conditions to allow connection of stand-by temporary generator to station while the switchboard is still energized, and allow transition to stand-by temporary generation to occur with minimum outage, if any. The intent is to provide a method to source low voltage building loads, while isolating medium voltage system, maintain building loads and to de-energized medium voltage sources.

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ALTERNATE #4: Prepare a proposed plan which includes a conceptual design, logistics and construction line item for the listed item below. Refer to scope below and the one-line diagram in Appendix 4.12.

Scope: Provide usage meter for 12.5kV feeder for “SC2-204” prior to terminating to existing 1MVA transformer. Include all cost with termination, installation, stand-by mobilization, shutdown, usage, demobilization, routing and labor.

ADD COST: $_______________

4. The substantial completion date shall be January 6, 2016. The final completion date shall be January 31, 2016. 5. The Undersigned certifies that: (1) This bid has been arrived at independently and is being submitted without collusion with and without any agreement, understanding, or planned common course of action with any other vendor of materials, supplies, equipment or services described in the invitation to bid designed to limit independent bidding or competition; and (2) The contents of the bid have not been communicated by the Undersigned or its employees or agents to any person not an employee or agent of the Undersigned and will not be communicated to such person prior to the official opening of the bid.

6. The undersigned HAS, HAS NOT (circle applicable status) paid unemployment or income taxes in Oregon within the past 12 months and HAS, HAS NOT (circle applicable status) a business address in Oregon.

7. The Undersigned agrees, if awarded a contract, to comply with the provisions of ORS 279C.800 through 279C.870 pertaining to the payment of the prevailing rates of wage.

8. Contractor's CCB registration number is ____________________________. As a condition to submitting a bid, a Contractor must be registered with the Oregon Construction Contractors Board in accordance with ORS 701.035 to 701.055, and disclose the registration number. Failure to register and disclose the number will render the bid unresponsive and it will be rejected, unless contrary to federal law.

9. The successful bidder hereby certifies that all subcontractors who will perform construction work as described in ORS 701.005(2) were registered with the Construction Contractors Board in accordance with ORS 701.035 to 701.055 at the time the subcontractor(s) made a bid to work under the Contract.

10. The successful bidder hereby certifies that, in compliance with the Worker's Compensation Law of the State of Oregon, its Worker's Compensation Insurance provider is ______________________________, Policy No. , and that Contractor shall submit Certificates of Insurance as required.

11. Contractor’s Project Manager for this project is: ________________________________________,

Office Phone: ___________________________________ Cell Phone: _______________________________________. 12. The Undersigned certifies that it has not discriminated against minority, women, or emerging small businesses in obtaining any subcontracts for this project.

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PSU BID FORM Page 4 of 4 By signature below, Contractor agrees to be bound by this bid.

NAME OF FIRM _______________________________________ ADDRESS _______________________________________ _______________________________________ FEDERAL TAX ID _______________________________________ TELEPHONE NO _______________________________________ FAX NO _______________________________________ SIGNATURE 1) _______________________________________ Sole Individual or 2) _______________________________________ Partner or 3) _______________________________________ Authorized Officer of Corporation

(SEAL)

_______________________________________ Attested: Secretary of Corporation

Payment information will be reported to the IRS under the name and taxpayer ID # provided above.

Information not matching IRS records could subject Contractor to 31 percent backup withholding.

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BID SECURITY FORM

We, _____________________________________, as “Principal,” (Name of Principal)

and ___________________________________, an _________________ Corporation, (Name of Surety)

authorized to transact Surety business in Oregon, as “Surety,” hereby jointly and severally bind ourselves, our respective heirs, executors, administrators, successors and assigns to pay unto Portland State University (“Obligee”) the sum of ($__________________) __________________________________________________________________ dollars. WHEREAS, the condition of the obligation of this bond is that Principal has submitted its proposal or bid to an agency of the Obligee in response to Obligee’s procurement document (#1565) for the project identified as West Loop Medium Voltage Testing & Maintenance (MVT&M) which proposal or bid is made a part of this bond by reference, and Principal is required to furnish bid security in an amount equal to ten (10%) percent of the total amount of the bid pursuant to the procurement document.

NOW, THEREFORE, if the proposal or bid submitted by Principal is accepted, and if a contract pursuant to the proposal or bid is awarded to Principal, and if Principal enters into and executes such contract within the time specified in the Instructions to Bidders and executes and delivers to Obligee its good and sufficient Performance Bond and Payment Bond required by Obligee within the time fixed by Obligee, then this obligation shall be void; otherwise, it shall remain in full force and effect.

IN WITNESS WHEREOF, we have caused this instrument to be executed and sealed by our duly authorized legal representatives this ________________day of _________________________, 20____.

PRINCIPAL: ____________________________ SURETY: ___________________________ BY:________________________________________ BY ATTORNEY-IN-FACT:

Signature

_______________________________________ _______________________________________

Official Capacity Name

______________________________________ Attest: _________________________________ Signature

_______________________________________

Corporation Secretary Address

_______________________________________ City, State, Zip

_____________ ________________

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