retainer rfq part 'c' forms · rfq retainer for ca - version 1.7, march 2018 assignment...

REQUEST FOR QUOTATION DOCUMENT

TO PROVIDE CONTRACT ADMINISTRATION

RETAINER SERVICES

PART C – FORMS AND NOTICES

Version 1.7

March 2018

RFQ Retainer for CA - Version 1.7, March 2018 Assignment Number: INSERT

REQUEST FOR QUOTATION

FORM 1 OFFER ACCEPTANCE

The Ministry hereby accepts the Offer for this Assignment made by the Preferred Proponent _____________________ to provide the Services and Deliverables (Name of the Service Provider) specified in the RFQ annexed hereto and forming part hereof, in accordance with the RFQ, including the Terms and Conditions, and has caused its duly authorized official to execute this Acceptance on this _______ day of ______________, 201_. The term of this Agreement is from _______ to _______. The Preferred Proponent has been issued Agreement No. ____________ for the purposes of this Retainer. HER MAJESTY THE QUEEN in right of the Province of Ontario, represented by the Minister of Transportation of the Province of Ontario

Authorized Ministry Representative ____________________________________

(Title) ____________________________________

(Telephone Number) ____________________________________



FORM 2 - ADDITIONAL INFORMATION

2. BRIEF HISTORY OF PROPONENT’S ORGANIZATION

2.1 Legal Name of Business: ___________________________________________

2.2 OWNER(S); PARTNER(S); CORPORATE OFFICER(S)/TITLE:

2.3 BUSINESS ADDRESS: Street, City, Province, Postal Code

Telephone Number

Facsimile Number

2.4 IDENTIFICATION OF PROJECT MANAGER

2.5 POSITION AND QUALIFICATIONS OF EACH OF THE STAFF MEMBERS ASSIGNED IN RELATION TO THIS RFQ.

Only attach Resumes for positions requiring resumes in the Project Terms of Reference. All resumes must be accompanied by a consent form signed by the individual to the disclosure of the resume.

(NOTE: The Freedom of Information and Protection of Privacy Act Prohibits indirect collection of personal information without the consent of the individual concerned).

The response to this section shall also include the firm’s agreement to the following statement, Legal Name of Service Provider hereby declares to the Ministry that staff of sufficient numbers and qualifications will be provided as necessary at all times during this assignment.

2.6 PREVIOUS EXPERIENCE OF THE PROPONENT WITH REFERENCE TO THE PROJECT DESCRIPTION, DELIVERABLES AND SERVICES

2.7 SUMMARY IN NARRATIVE FORM OF THE PROPONENT'S UNDERSTANDING OF THE PROJECT TASKS AND DELIVERABLES AND SERVICES

Note to Proponents: The responses to Section 3 shall be combined into a single narrative written from an overview perspective and of no more than one (1) page in length. The narrative shall also include the proponent’s agreement to the statement “in the event of any conflicts between the requirements of the RFQ document and the content of the narrative response Section 3 then the content of the RFQ shall take precedence over the narrative.



FORM 3(a) - CERTIFICATION - CONFLICT OF INTEREST (Complete 3(a) OR 3(b))

Assignment Number: _____________

I/we hereby certify that there is not / nor was there any actual or potential conflict of interest or unfair advantage in this Submission or performing the Work/Services required by this Agreement. In submitting this Submission, our company has no knowledge of or the ability to avail ourselves of confidential information of the Crown (other than confidential information which may be been disclosed by the Ministry to the Service Providers in the normal course of the Request for Quotations) where the confidential information would be relevant to the Work/Services, their pricing or the Request for Quotations evaluation process. Dated at______________ this ____ day of _____________, 20____

An Authorized Signing Officer

(Contact/Alternate Contact listed in RAQS) ___________________________________

(Title) ___________________________________

(Firm’s Address) ___________________________________

(Telephone Number) ___________________________________



FORM 3(b) - CERTIFICATION - CONFLICT OF INTEREST (Complete 3(a) OR 3(b))


In submitting this Submission, the Proponent declares that the attached is a list of situations, each of which may be a conflict of interest, or appears as potentially a conflict of interest in our company submitting the Submission or performing the contractual obligations of the Service Provider under the Agreement. (Strike out Paragraph if not Applicable) In submitting this Submission, our company has/has no (Strike out the inapplicable portion) knowledge of or the ability to avail ourselves of confidential information of the Crown (other than confidential information which may have been disclosed by the Ministry to the Proponents in the normal course of the Request for Quotations) where the confidential information would be relevant to the Work/Services, their pricing or the Request for Quotations evaluation process and where access to such additional information may prejudice the Crown or be an unfair advantage to the Service Provider. (If declaring that the Proponent has access to additional information that may be confidential, other than confidential information that may be disclosed by the Ministry to the Service Providers in the normal course of the Request for Quotations, please attach an explanation describing the additional information and how you accessed it.) With the exception of those situations and/or access to additional information disclosed on the list attached, I/we hereby certify that there is not nor was there any other actual or potential conflict of interest or unfair advantage in our submitting the Quotation or performing the Work/Services required by this Agreement. I/We hereby acknowledge that the Ministry in its sole discretion shall have the right to determine whether or not the declared situations do constitute an actual or potential conflict of interest or whether access to additional confidential information does constitute an unfair advantage over other Proponents. I/We acknowledge that in the event that the Ministry finds the situations to be a conflict of interest or access to the additional confidential information to be an unfair advantage that our Submission may be rejected. Dated at _______________________ this ____ day of __________, 20


(Contact/Alternate Contact Listed in RAQS) ___________________________________

(Title) ___________________________________



FORM 3(c) – LIST OF PEOPLE WHO PARTICIPATED IN PREPARATION OF THIS QUOTATION SUBMISSION

(Must be completed)


NAME:

ADDRESS:

TELEPHONE NUMBER:

CONTRIBUTION OR % OF WORK:

Dated at _______________________ this ____ day of __________, 20


(Contact/Alternate Contact listed in RAQS) ___________________________________

(Title) ___________________________________

(Firm’s Address) ___________________________________

(Telephone Number) ___________________________________



FORM 4 - OCCUPATIONAL HEALTH AND SAFETY STATUTORY DECLARATION


In submitting this Quotation Submission

I/we, on behalf of ____________________________________, certify the following: (legal name of company)

(a) I/We have a health and safety policy and will maintain a program to implement

such policy as required by clause 25(2)(j) the Occupational Health and Safety Act, R.S.O. 1990, c.O.1, as amended, (the "OHSA").

The requirements in (a) do not apply to employers with five (5) or less employees.

(b) With respect to the Services being offered in this Quotation, I/we and our

proposed sub-contractor, acknowledge the responsibility to, and shall: (i) fulfill all of the obligations under the OHSA and make reasonable efforts so

that all work is carried out in accordance with the OHSA and its regulations. (ii) make reasonable efforts so that adequate and competent supervision is

provided as per the OHSA to protect the health and safety of workers; and (iii) provide information and instruction to all employees to so that they are

informed of the hazards inherent in the work and understand the procedures for minimizing the risk of injury or illness.

(c) I/We agree to take every precaution reasonable in the circumstances for the

protection of worker health and safety, as required under the OHSA. Dated at ____________________ this ____ day of _________________, 201_

An Authorized Signing Officer (Contact/Alternate Contact listed in RAQS)

_________________________________

(Title) __________________________________

(Telephone Number) __________________________________

(Firm’s Name) __________________________________

(Firm’s Address) __________________________________



FORM 5 – RAQS DECLARATION FORM

Assignment Number: _____________ In submitting this Quotation, I/We, on behalf of _______________________________ (legal name of company), hereby certify that our company is approved in RAQS for this Prime/RFQ Specialty and has verified that (check one of the following):

The Personnel approved in RAQS for this specialty are current and valid; or

The Personnel approved in RAQS for this Specialty are no longer current and valid, and the information for the Personnel replacement has been ‘Submitted For Approval’ in RAQS on _______________ (date).

Also hereby certify that our company has the prior registration of the Core Plan and for the Generic Category Plan for the Category where Prime/RFQ Specialty is located.

_____________Specialty _____________Category

(Note: Prime Specialty applies to multi-specialty agreements, while RFQ specialty applies to single specialty situations). Dated at ________________________ this ____ day of _____________________, 201_


(Contact/Alternate Contact listed in RAQS)

____________________________________

(Title) ____________________________________


(Firm’s Name) ____________________________________

(Firm’s Address) ____________________________________



FORM 6 – Option ‘A’ OR ‘B’ – N/A HOURLY BILLING RATES FEE SCHEDULE

Assignment Number: (insert number)

TO: Her Majesty the Queen in right of Ontario, represented by the Minister of Transportation for the Province of Ontario (the "Ministry).

FROM: (the "Proponent") ADDRESS: The Service Provider hereby tenders and offers to enter into a contract to provide the Services specified for this Assignment, for the hourly billing rates of:

Staff Positions Hourly Billing Rates

Project Manager $ /hour

Road Construction Contract Administrator $ /hour

Road Construction Senior Inspector $ /hour

Road Construction Junior Inspector $ /hour

Electrical Inspector $ /hour

ATMS Inspector $ /hour

Office Person $ /hour

Checker $ /hour

Environmental Specialist $ /hour

Structural Specialist $ /hour

Equipment costs Note to user: Only use when necessary for the Assignment.

$ /hour

Daily expense rate Note to user: Only use when necessary for the Assignment. This can be added for each necessary position.

$ /hour

SAMPLE DELIVERY

Activity Cost per Day per trip $

Sample Delivery (Maximum 1 trip per day) $ per Day per trip

Sample Delivery to Regional QA Laboratory (Maximum 1 trip per day)

$ per Day per trip

Sample Delivery to MTO MERO Laboratory (Maximum 1 trip per day)

$ per Day per trip


and agrees that upon acceptance of this Offer by the Ministry, this Offer, the RFQ (Parts A, B, and C) to which this Offer is attached, and the successful Service Provider's Quotation Submission shall form a legally binding Agreement. *Daily expense rate” means the daily cost to the Ministry per individual for living and travel expenses. Note to user: Select Option A or B and change title of this Form accordingly. Option A – Weighted Hourly Billing Rate: Hourly cost to the Ministry per individual staff position inclusive of costs for: salary, benefits, overhead, payroll burden, profit, and Daily expense rate* and equipment costs. Site office costs are included in the Blended Rate. All Hourly Billing Rates are to include travel time. Option B – Hourly Billing Rate: Hourly cost to the Ministry per individual staff position inclusive of costs for: salary, benefits, overhead, payroll burden and profit. All Hourly Billing Rates are to include travel time. 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 Offer shall be irrevocable and open for acceptance for a period of ninety (90) days following the Quotation Submission Date. Dated at ________________________ this ____ day of _________________, 201_

An Authorized Signing Officer: (Contact/Alternate Contact listed in

RAQS)

Title:

Telephone Number:

Firm’s Name:

Firm’s Address:


REQUEST FOR QUOTATION FORM 6 – Option ‘C’ – N/A

HOURLY RATES AND EXPENSES FEE SCHEDULE

Assignment Number: (insert number)

TO: Her Majesty the Queen in right of Ontario, represented by the Minister of Transportation for the Province of Ontario (the "Ministry).

FROM: (the “Proponent”)

ADDRESS:

The Service Provider hereby tenders and offers to enter into a contract to provide the RETAINER Services specified, for this Assignment for the billing rates of:

Staff Position Billing Rate


Mobilization Rate $ /km

Road Construction Contract Administrator $ /hour

Daily Travel Rate $ /day

Daily Living Expense Rate $ /day














Checker $ /hour




SAMPLE DELIVERY

Activity Cost per Day per trip $


$ per Day per trip


$ per Day per trip

Note to user: Northwestern Region to add or edit this form as needed.


and agrees that upon acceptance of this Offer by the Ministry, this Offer, the RFQ (Parts A, B, and C) to which this Offer is attached, and the successful Service Provider's Quotation Submission shall form a legally binding Agreement. Hourly Billing Rate – the price in dollars per hour, which shall be full compensation for employee remuneration, payroll burden, Head Office and Job Overheads (excluding site office expenses) and profit. Daily Travel Cost – the cost for travel while working on the contract site. Daily Living Expense Rate – the cost living expenses while working on the contract site. This rate is applicable to working days which include overnight travel only. Mobilization Rate is the cost per kilometre for travel from the principal or alternate mobilization point, whichever is closest, to and from the contract site. Site Office and other requisite expenses not included in the above rates will be considered where necessary with proper justification and approval of the Ministry. The compensation for other expenses will be cost plus 5% mark-up. This Offer shall be irrevocable and open for acceptance for a period of ninety (90) days following the Quotation Submission Date. Dated at ________________________ this ____ day of _________________, 200_



____________________________________

(Title) ____________________________________


(Firm’s Name) ____________________________________

(Firm’s Address) ____________________________________



FORM 7 - CHECK LIST OF MANDATORY DOCUMENTS REQUIRED FOR QUOTATION

Each of the following requirements is a part of this RFQ. Proponents shall indicate that they have included these required documents in their Quotation Submission.

Document

Included

Transmittal Letter Yes or No

RAQS Declaration Form Yes or No

Occupational Health & Safety Statutory Declaration Form Yes or No

Conflict of Interest Declaration Forms (Form 3A or 3B) Yes or No

List of Proponent`s Staff Who Participated In Preparation of the RFQ Submission (Form 3C)

Yes or No

The format of the Proponent’s submission is complete and consistent with the RFQ requirements.

Yes or No

Fee Schedule (Form 6) Yes or No

Dated at ________________________ this ____ day of _____________________, 201_



____________________________________

(Title) ____________________________________


(Firm’s Name) ____________________________________

(Firm’s Address) ____________________________________



FORM 8A – N/A WORK ITEM ORDER

Assignment No.: (insert number)

Order (Work Item) No.: (insert number)

ORDER

The Ministry hereby issues to the Service Provider a Work Item Order under the Agreement no. (insert number). The details of the Work Item are as follows: This Work Item is for the Contract Administration of construction contract 200X-XXXX, located on Highway XXX, from X to X, for X km. Note to user: Fill in the specific requirements of the Contract Administration Services that are required under this Work Item Order. These requirements shall include start date and duration noting start date is to include adequate mobilization time appropriate for the Ministry’s needs and the Service Providers resource allotment / scheduling, minimum ten (10) business days. Note to user: Delete options in the paragraph below which does not apply. For Capital Construction Contract Documents, including any addenda, for all contracts, are to be purchased, using the Ministry’s RAQS/MERX System. Visit the RAQS/MERX site to register. An annual subscription is required to purchase the contract documents in an electronic format or by an additional fee to obtain contract documents in hard copy format. The successful Service Provider is responsible for obtaining and printing the Contracts Documents through the Ministry’s RAQS/MERX

http://www.raqs.merx.com/

http://www.raqs.merx.com/


Note to user: Fill in the specific requirements of the Construction Contract Administration Services that are required under this Work Item Order. Note to user: This table should be applicable when the project-specific information is available to share with the Service Provider. Delete table in its entirety when not applicable as determined by the Area Contracts Engineer.

Number of staff

Staff Positions / Testing / Equipment/Supplies and Office

Maximum Days

Maximum Hours

Project Manager(s) Days Hours

Road Construction Contract Administrator(s) Days Hours

Road Construction Senior Inspector(s) Days Hours

Road Construction Junior Inspector(s) Days Hours

Electrical Inspector Days Hours

ATMS Inspector Days Hours

Office Person Days Hours

Checker(s) Days Hours

Environmental Specialist Days Hours

Structural Specialist NOTE TO USER: Please specify/add the specialist needed for your Assignment. Delete the ones not needed.

Days Hours

Foundations Specialist NOTE TO USER: Please specify/add the specialist needed for your Assignment. Delete the ones not needed.

Days Hours

Electrical Specialist NOTE TO USER: Please specify/add the specialist needed for your Assignment. Delete the ones not needed.

Days Hours

Testing / Equipment, Supplies and Office Maximum Units

Field Testing – Compaction Tests

Field Testing - Pavement Smoothness Tests

Field Testing – Concrete Covermeter Survey Tests

Field Testing – Concrete Half Cell Survey Hours

Equipment, Supplies and Office Months

SAMPLE DELIVERY

Activity Cost per Day

per trip Maximum

Trips

Sample Delivery (Maximum 1 trip per day) $ per Day per

trip


$ per Day per trip


$ per Day per trip


Designated Substances

Designated Substance Location or Work Activity

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. The Service Provider shall confirm its availability and shall provide the Ministry with a completed Form 8B, Work Item Quote Form within three (3) business days of receiving this Work Item Order.

Dated at ________________________ this ____ day of _________________, 201_ Authorized Ministry Representative

____________________________________

(Title) ____________________________________




FORM 8B – N/A WORK ITEM QUOTE FOR OPTION ‘A’ WEIGHTED HOURLY BILLING RATES


Work Item Order No.: (insert number)

TO: Her Majesty the Queen in right of Ontario, represented by the Minister of

Transportation for the province of Ontario (the "Ministry). FROM: (the "Service Provider") ADDRESS: The Service Provider hereby offers to complete Work Item Order No. (insert number), charging the Ministry only for the following (at the Ministry accepted staff billing rates offered in Fee Schedule Form 6A of the Quotation and the Work Item Order specific rates for the other Services listed in this Order Quote Form 8B): This Work Item Order is for the Contract Administration Services of Contract 200X-XXXX, located on Highway XXX, from X to X, for X km, as described in Form 8A. These Services are to be delivered in accordance with the Contract Administration Retainer Agreement.

Staff Positions / Testing /

Equipment , Supplies and

Office

Quantity

(a)

Weighted Hourly Billing Rates

(b)

Number of Days

(c)

Daily Expense Rate* See

Note 1

(d)

Total (axb) + (cxd) for

staff, and expenses and

(axb) for testing and equipment,

supplies and office.

Project Manager hrs

$ /hour

Days $ /day $

Road Construction Contract Administrator

hrs

$ /hour

Days $ /day $

Road Construction Senior Inspector(s)

hrs

$ /hour

Days $ /day $

Road Construction Junior Inspector(s)

hrs

$ /hour

Days $ /day $


Electrical Inspector(s)

hrs

$ /hour

Days $ /day $

ATMS Inspector(s) hrs

$ /hour

Days $ /day $

Office Person hrs

$ /hour

Days $ /day $

Checker(s) hrs

$ /hour

Days $ /day $

Environmental Specialist

hrs

$ /hour

Days $ /day $


hrs

$ /hour

Days $ /day $


hrs

$ /hour

Days $ /day $


hrs

$ /hour

Days $ /day $

Field Testing – Compaction

Tests

$ /test

$

Field Testing - Pavement Smoothness

Tests

$ /test

$

Field Testing – Concrete Covermeter Survey

Tests

$ /test

$

Field Testing – Concrete Half Cell Survey

Tests

$ /test

$

Equipment, Supplies and Office

Months

$ /month

$


SAMPLE DELIVERY

Activity Number of Trips

(A) Cost per Day per trip $

(B) Total $ (A * B)

Sample Delivery (Maximum 1 trip per day) Note to user: Use if 1 rate is used for your Assignment.

Note to user: MTO to provide estimate on # of

trips.

Sample Delivery to Regional QA Laboratory (Maximum 1 trip per day) Note to user: Use 2 different delivery rates are required for your Assignment (MERO, Lab)


trips.

Sample Delivery to MTO MERO laboratory (Maximum 1 trip per day) Note to user: Use 2 different delivery rates are required for your Assignment (MERO, Lab)


trips.

Total $

Weighted Hourly Billing Rate - Hourly cost to the Ministry per individual staff position inclusive of following costs: salary, benefits, overhead, payroll burden and profit, excluding Daily expense rate* and equipment costs. *Daily expense rate” means the daily cost to the Ministry per individual for living and travel expenses.


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. I/We hereby certify that ___________________, have sufficient staff with valid Name of Company and applicable OACETT certification and designations as required for this Work Item Order. I/We hereby certify that ___________________, at the time of submitting this Name of Company Quote have no conflict of interest in the performance of this Work Item Order. Dated at ________________________ this ____ day of _________________, 201_



____________________________________

(Title) ____________________________________


(Firm’s Name) ____________________________________

(Firm’s Address) ____________________________________



FORM 8B – N/A WORK ITEM QUOTE FOR OPTION ‘B’

HOURLY BILLING RATES


Work Item Order No.: (insert number) TO: Her Majesty the Queen in right of Ontario represented by the Minister of

Transportation for the province of Ontario (the "Ministry). FROM: (the "Service Provider") ADDRESS: The Service Provider hereby offers to complete Work Item Order No. (insert number), charging the Ministry only for the following (at the Ministry accepted staff billing rates offered in Fee Schedule Form 6B of the Quotation and the Work Item Order specific rates for the other Services listed in this Order Quote Form 8B): This Work Item Order is for the Contract Administration Services of Contract 200X-XXXX, located on Highway XXX, from X to X, for X km, as described in Form 8A. These Services are to be delivered in accordance with the Contract Administration Retainer Agreement.

Position Quantity

(Hours/Days) (a)

Hourly Billing Rates

(b)

Total (c = a x b)

Project Manager

$ $


$ $

Road Construction Senior Inspector $ $

Road Construction Junior Inspector $ $

Electrical Inspector $ $

ATMS Inspector $ $

Office Person $ $

Checker $ $

Environmental Specialist $ $



$ $


$ $


$ $

SAMPLE DELIVERY


(A)

Cost per Day per trip $

(B)

Total $ (A * B)

Activity


Note to user: MTO to provide estimate on #

of trips.



of trips.

Sample Delivery to MTO MERO laboratory (Maximum 1 trip per day)


of trips.


Note to user: Use 2 different delivery rates are required for your Assignment (MERO, Lab)

Total $: $

Hourly Billing Rates – shall be the total amount payable for all Services, Deliverables, supplies and testing required to provide the Construction Contract Administration Services under this Retainer. Hourly Billing Rates are the hourly cost to the Ministry per individual staff position inclusive of costs for: salary, benefits, overhead, payroll burden and profit, excluding Daily expense rate* and equipment costs. All Hourly Billing Rates are to include travel time. *Daily expense rate” means the daily cost to the Ministry per individual for living and travel expenses. 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. I/We hereby certify that ___________________, have sufficient staff with valid Name of Company and applicable OACETT certification and designations as required for this Work Item Order. I/We hereby certify that ___________________, at the time of submitting this Name of Company Quote have no conflict of interest in the performance of this Work Item Order. Dated at ________________________ this ____ day of _________________, 201_


An Authorized Signing Officer (Contact/Alternate Contact listed in

RAQS)

____________________________________

(Title) ____________________________________ (Telephone Number) ____________________________________

(Firm’s Name) ____________________________________ (Firm’s Address) ____________________________________


FORM 8B – N/A WORK ITEM QUOTE FOR OPTION ‘C’

HOURLY RATES AND EXPENSES FEE SCHEDULE


Work Item Order No.: (insert number) TO: Her Majesty the Queen in right of Ontario, represented by the Minister of

Transportation for the province of Ontario (the "Ministry). FROM: (the "Service Provider") ADDRESS: The Service Provider hereby offers to complete Work Item Order No. (insert number), charging the Ministry only for the following (at the Ministry accepted staff billing rates offered in Fee Schedule Form 6C of the Quotation and the Work Item Order specific rates for the other Services listed in this Order Quote Form 8B): This Work Item Order is for the Contract Administration Services of Contract 200X-XXXX, located on Highway XXX, from X to X, for X km, as described in Form 8C. These Services are to be delivered in accordance with the Contract Administration Retainer Agreement.

Staff Position Quantity Billing Rate Total


$

Mobilization Rate $ /km $


$ /hour

$

Daily Travel Rate $ /day $

Daily Living Expense Rate $ /day $



$





$





Staff Position Quantity Billing Rate Total


$




Checker $ /hour

$




SAMPLE DELIVERY


(A)

Cost per Day per trip

$ (B)

Total $

(A * B)



of trips.



of trips.

Sample Delivery to MTO MERO laboratory (Maximum 1 trip per day) Note to user: Use 2 different delivery rates are required for your Assignment (MERO, Lab)


of trips.

Total $: $

Note to user: Northwestern Region to add or edit this form as needed. 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. I/We hereby certify that ___________________, have sufficient staff with valid Name of Company


and applicable OACETT certification and designations as required for this Work Item Order. I/We hereby certify that ___________________, at the time of submitting this Name of Company Quote have no conflict of interest in the performance of this Work Item Order. Dated at ________________________ this ____ day of _________________, 201_



____________________________________

(Title) ____________________________________


(Firm’s Name) ____________________________________

(Firm’s Address) ____________________________________



FORM 8C – N/A ACCEPTANCE OF WORK ITEM QUOTE



The Ministry hereby accepts the Work Item Quote made by the Service Provider _____________________ to provide the Services and Deliverables specified in (Name of the Service Provider) the RFQ annexed hereto and forming part hereof, in accordance with the RFQ, including the Terms and Conditions, and has caused its duly authorized official to execute this Acceptance on this _______ day of ______________, 201_. HER MAJESTY THE QUEEN in right of the Province of Ontario, represented by the Minister of Transportation of the Province of Ontario

Authorized Ministry Representative

____________________________________

(Title) ____________________________________

(Telephone Number)

____________________________________



FORM 8D – N/A NON-ACCEPTANCE OF WORK ITEM QUOTE



The Ministry hereby does not accept the Work Item Quote submitted by the Service Provider _____________________ to provide the Services and Deliverables

(Name of the Service Provider) Specified in the RFQ annexed hereto, and has caused its duly authorized official to execute this Non-Acceptance on this _______ day of ______________, 201_. HER MAJESTY THE QUEEN in right of the Province of Ontario, represented by the Minister of Transportation of the Province of Ontario

Authorized Ministry Representative ____________________________________

(Title)
