Submit this completed form with the required attachments and bid security. Prices are firm for 60 calendar days after opening. Fill every price line; use zero where included elsewhere and explain the allocation. Do not count the same cost twice.

Legal bidder name: ___

Address: ___

Contact / title: ___

Phone / email: ___

lowa contractor registration / elevator contractor license: ___

Base bid breakdown Amount

New cab package, doors, finishes, ventilation, and lighting $___

NEW RECESSED CAR OPERATING STATION: enclosure/panel, buttons, mounting, $___

wiring and integration

New car position indicator, phone, and lantern $___

New sling/platform, guides, sill, toe guard and data plate $___

Survey, submittals, removal, installation, and adjustment $___

Permits, testing, inspection, and closeout $___

Bonds, insurance, shipping, overhead and all other base costs $___

TOTAL BASE BID — sum of all lines $___

Total base bid in words: ___

Bid security enclosed: $_____ (5% of total base bid).

Form: [] Cashier's check [] Corporate surety bid bond

Surety / issuer: ___

Deduct Alternate DA-1: Complete the attached alternate pricing sheet for reuse of compatible existing devices. The recessed car operating panel remains new under both the base bid and DA-1.

Addenda acknowledged by number and date: ___

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