INVITATION TO QUALIFY FOR

ROAD-KILLED DEER REMOVAL AND DISPOSAL

ISSUING OFFICE

DEPARTMENT OF TRANSPORTATION

ITQ NUMBER

3510T01

DATE OF ISSUANCE

4/15/2011

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INVITATION TO QUALIFY (ITQ)

ROAD-KILLED DEER REMOVAL AND DISPOSAL

CONTRACT # 3510T01

TABLE OF CONTENTS Calendar of Events…………………………………………………………………………….…3 Definitions………………………………………………………………………………………..4 Part I— Statement of Work ……………………………………………………………………..5 Part II—ITQ Process………………………………………………………………………….….9 Part III— Request for Quote (RFQ) Process…..……………………………….……………….11 Part IV—Application Requirement …………………………………………………………….16 Contract Signature Page………………………………………………………………...………19 Exhibit A Standard Contract Terms and Conditions (STD 274) Exhibit B Special Contract Terms and Conditions Exhibit C Pennsylvania Game Commission Special Study of CWD Exhibit D Location Sheet Exhibit E Disposal Sites Exhibit F Request for Quote (sample) Exhibit G Purchase Order (sample) Exhibit H Contractor Notification Log (sample) Exhibit I Invoice (sample) Exhibit J Confirmation of Services (sample)

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INVITATION TO QUALIFY (ITQ)

Commonwealth of Pennsylvania Department of Transportation

PROCUREMENT OF ROAD-KILLED DEER REMOVAL AND DISPOSAL SERVICES

CALENDAR OF EVENTS

Activity Responsibility Due By Date

Submit questions regarding this ITQ are to Contracting Officer no later than 3:00 p.m. on: Contact Person for all ITQ questions: Nadine Chinapoo at nchinapoo@state.pa.us

Potential Contractors 4/22/2011

Responses to questions shall be posted to the DGS website at: http://www.dgsweb.state.pa.us/RTA/Search.aspx Issuing Office 4/29//2011

Initial Application Period shall close: Sealed applications must be received by the Issuing Office no later than 4:00 PM at: Pennsylvania Department of Transportation Bureau of Office Services Attn: Nadine Chinapoo, Contracting Officer 400 North Street, 5th Floor Harrisburg, PA 17120

Potential Contractors 5/06/2011

Open Enrollment: Applications shall continue to be accepted at the address above until 4:00 p.m. on 10/31/2015.

Potential Contractors 10/31/2015

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DEFINITIONS

For the purposes of this ITQ, the following definitions shall apply: ♦ Contract: The Contract executed as a result of this ITQ.

♦ Contracting Officer: The person authorized to administer this Contract for PennDOT

and to make written determinations with respect to the Contract.

♦ Initial Application Period: Applications submitted for qualification between ITQ release date and May 6, 2011. All completed applications received during the initial application period shall be processed as a batch prior to processing applications received during the Open Enrollment.

♦ Issuing Office: PennDOT Office issuing the ITQ.

♦ Open Enrollment: This refers to the period beginning the day after the due date for

Initial Applications through October 31, 2015, where Contractors can submit their Applications for qualification under this ITQ.

♦ Purchasing Office: The PennDOT organization issuing the Request for Quote (RFQ)

for service covered under this ITQ as well as the ensuing Purchase Order.

♦ Purchasing Office Contact Person: Person in the PennDOT organization referenced in the RFQ process and on Purchase Order.

♦ Request For Quote (RFQ): A document that describes the required services and

provides interested Qualified Contractors with sufficient information to enable them to prepare and submit quotes. At PennDOT’s discretion, RFQs may be issued through mail, facsimile or electronic mail.

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PART I

STATEMENT OF WORK

Scope: To remove and lawfully dispose of clearly visible dead deer (or major parts thereof) that can result in hazardous driving conditions along or within PennDOT’s right-of-ways, highways, and interchanges throughout the Commonwealth. All work shall be awarded through a Request for Quote (RFQ) as described in Part III. Details on required service shall be provided on the RFQ. General Tasks: Selected Contractors shall be required to complete the following tasks:

A. Schedule Kickoff Meeting: Selected Contractor is required to contact the Maintenance

Manager within ten (10) days of receipt of a Purchase Order to develop a comprehensive work plan for the Road-Killed Deer Removal and Disposal services. Items to be discussed include (but are not limited to): i. Pick-up notification process. The contractor must provide one phone number with a

form of answering service (answering machine or individual) approved by PennDOT, to accept verbal messages regarding the location of road-killed deer. Phone coverage MUST be available for use 7 days a week, 24 hours a day.

ii. Acceptable storage requirements prior to disposal.

iii. Procedure for pick up of deer found prior to PennDOT notification.

iv. Invoice (reference Exhibit I), Contractor Notification Log (reference Exhibit H), OS-501-Confirmation of Services Form (reference Exhibit J), and disposal facility receipts submission process.

B. Clean up/removal: PennDOT shall provide locations of road-killed deer to the

contractor. The contractor shall be required to remove the deer and/or deer pieces within 24-hours of notification, unless otherwise directed by Maintenance Manager. Leaving a message with the contractor’s answering service fulfills PennDOT’s notification obligation.

i. If the contractor does not remove the carcass within the assigned timeframe and does

not notify the Purchasing Office Contact Person immediately of the anticipated delay, PennDOT reserves the right to take the following measures including, but not limited to: (1) removing the carcass by another method and contractor shall not be paid for the call; and (2) entering the contractor into the Commonwealth’s Contractor Responsibility Program (CRP).

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ii. If the deer (or major parts thereof) is no longer physically there when the contractor arrives, the contractor shall be paid the ‘Call-Out” cost for responding to the call. This situation must be reported immediately to PennDOT and noted on the OS-501 and Contractor Notification Log.

iii. If the animal is not a deer, the contractor must not pick-up the animal. Contractor shall be paid the “Call-Out” cost for responding to the call. This situation must be reported immediately to PennDOT and noted on the OS-501 and Contractor Notification Log.

iv. If a deer is not dead, the contractor must immediately inform PennDOT, the State

Police, local police, or the Game Commission. When a police officer or Game Commission officer has killed the animal, the contractor may remove the carcass.

v. Should the contractor find or learn about a road-killed deer before being notified by PennDOT, the contractor must obtain approval from PennDOT to proceed with the removal. The contractor shall not be paid for any deer removed and disposed of without prior PennDOT approval.

C. Disposal: The contractor shall dispose of deer at an approved disposal facility within

24-hours of pickup unless directed otherwise by PennDOT. PennDOT shall track pickup calls and compare contractor’s monthly disposal receipts and notification logs for compliance and payment.

i. When responding to a Request for Quote (RFQ), the contractor must state the

method of disposal and the disposal site to be used for each county in which it has expressed an interest to perform Road-Killed Deer Removal and Disposal services (refer to Exhibit E, “Disposal Sites”). PennDOT reserves the right to require the contractor to utilize an alternate disposal facility if it is in the best interest of the Commonwealth to do so.

ii. The contractor must contact the facility/municipal landfill/waste-to-energy facility

for further information about its acceptance of deer carcasses. Not every facility on the list is able to accept deer or other animal carcasses. If a rendering plant is selected as a disposal site, the contractor is not allowed to sell

the carcass to the plant. Rendering plants may use the hides; however, the contractor may not.

iii. If composting sites are used, deer that are added to the site must be covered within three (3) calendar days unless directed to do so sooner by PennDOT.

iv. Prior to disposal, contractor shall store any dead deer in accordance with applicable

Federal, State and Local regulations. Contractor must submit deer storage plans to Maintenance Manager for approval prior to implementation.

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v. The contractor shall obtain receipts from the disposal facility as proof of disposal. PennDOT reserves the right to monitor the accuracy of disposal receipts by inspecting loads prior to disposal or by contacting disposal sites.

D. Tagging Dead Deer as part of a special study for Chronic Wasting Disease:

PennDOT is assisting the Pennsylvania Gaming Commission (PGC) in conducting a study on Chronic Wasting Disease (CWD) affecting adult deer. The initial study shall be conducted in four (4) counties: Franklin, Fulton, Bedford and Somerset, and maybe extended to include additional counties as needed. Contractors shall be notified by the Purchasing Office Contact Person of their participation in the study. The Contracting Officer shall notify other counties as they are added to the study. Participating contractors should refer to Exhibit C, “Pennsylvania Game Commission Special Study of Chronic Wasting Disease (CWD)” for required procedures.

E. Safety Requirements: The contractor shall be held responsible for the safety of the general public and his/her employees while acting under the authority of this Contract. The contractor is required to: i. Follow all provisions of the Commonwealth Vehicle Code – Title 75. Pa.C.S. ii. Park vehicle completely off the traveling lane and in the same direction as moving

vehicles and as far away from the highway surface as possible. iii. Equip vehicles with a flashing or revolving yellow light mounted on the roof and

visible from the rear of the vehicle. This light must be activated at all times while the vehicle is stopped for pickup of carcasses.

iv. Ensure that all contractor personnel wear approved reflective safety vest and hard hats.

v. Carry and maintain a valid Driver’s license, vehicle registration and insurance when performing services under this Contract.

The contractor is not entitled to any special rights while working on the highways. The contractor must not interfere with the flow of traffic and is not authorized to use crossovers on highways. Safety training may be provided by PennDOT to Selected Contractors. The contractor shall perform all work as directed or in accordance with the following manuals:

→ PennDOT Work Zone Traffic Control (Publication 213) → PennDOT Maintenance Manual (Publication 23, Chapter 13, Section 5).

F. Equipment: The contractor shall be held responsible for supplying all equipment. The contractor is required to:

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i. Supply equipment which includes, but not limited to, revolving vehicle lights, safety vest, and hard hats.

ii. Provide an appropriate vehicle with current registration and inspection, capable of hauling and disposing of deer. Contractors may be required to have vehicle(s) inspected by PennDOT upon award of Contract to verify current inspection, registration, and suitability for performance of deer removal and disposal services.

G. Contractor Identification: The contractor and contractor’s employees are required to keep a copy of the current, valid Purchase Order as a form of identification in each vehicle used for road-killed deer removal and disposal while working on this Contract.

H. Notice of Delays: Whenever the contractor encounters any difficulty which is delaying or threatens to delay the timely performance of the Contract (including actual or potential labor disputes), the contractor shall immediately give notice thereof in writing to PennDOT Purchasing Office Contact Person stating all relevant information with respect thereto. Such notice shall not in any way constitute a basis for an extension of the delivery schedule or be construed as a waiver by PennDOT of any rights or remedies to which it is entitled by law or pursuant to the provisions of this Contract. Failure to give such notice, however, may be grounds for denial of any request for an extension of the delivery schedule because of such delay.

For any given county, the routes include the whole section of road from county line to county line (the part of the road contained within the county unless specifically noted). PennDOT reserves the right to delete roads by letter of notification to the contractor. No routes shall be added without written, mutual consent by both PennDOT and the contractor.

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PART II

ITQ PROCESS A. Purpose: The purpose of this Invitation to Qualify (ITQ) and resulting multiple-award

contracts, is to qualify responsible and responsive contractors for the Road-Killed Deer Removal and Disposal services for various locations throughout the Commonwealth of Pennsylvania.

This ITQ shall result in a contract that is the first step in a two-step procurement process. Only those contractors that respond to this ITQ and that the Department of Transportation (PennDOT) determines to be qualified (“Qualified Contractors”) shall be eligible to participate in the second step, the Request for Quote (RFQ) Process (see PART III).

B. Issuing Office: The Bureau of Office Services (“Issuing Office”) has issued this ITQ on

behalf of PennDOT. The sole point of contact in PennDOT for this ITQ shall be Nadine Chinapoo, the Contracting Officer for this ITQ. Please refer all inquiries to the PennDOT Contracting Officer via e-mail at nchinapoo@state.pa.us or via phone at (717) 705-4665, or such other person as designated by PennDOT in writing.

C. Initial Application Submission Due Date: The initial application submission deadline

for this ITQ is listed in the Calendar of Events. It is in the best interest of all contractors to submit the required information by the initial submission date in order to qualify for the full Contract period. Submissions must be delivered to the Issuing Office address listed in Calendar of Events.

It is the responsibility of each contractor to ensure that its application is received at the submission receipt location on or before the submission due date and time regardless of the medium used.

D. Open Enrollment For Applications: Applications shall continue to be accepted after

the initial application submission due date, however these applications shall be held until the initial applications have been processed. The Open Enrollment period shall end on October 31, 2015 at 4:00 p.m.

E. Incurring Costs: PennDOT is not liable for any costs or expenses incurred in the preparation and submission of the applications.

F. Rejection of Responses: PennDOT reserves the right to reject any or all responses to the ITQ and either re-advertise or cancel the project.

G. Modification to the ITQ: If it becomes necessary to revise any part of this ITQ, the Issuing Office shall post an addendum to the DGS website at

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http://www.emarketplace.state.pa.us. It is the contractor’s responsibility to periodically check the website for any new information or addenda to the ITQ.

H. Disclosure of Application Contents: All material submitted with the application shall be considered the property of the Commonwealth of Pennsylvania and may be returned only at the Issuing Office’s option. PennDOT shall have the right to make copies and distribute applications internally and to comply with public record or other disclosure requirements under the provisions of any Commonwealth or United States statute or regulation, or rule or order of any court of competent jurisdiction.

After the award of a contract pursuant to this ITQ, all applications are subject to disclosure in response to a request for public records made under the Pennsylvania Right-to-Know-Law (refer to Exhibit A, “Standard Contract Terms and Conditions”, Paragraph 31).

I. Questions and Answers: If a contractor has any questions regarding this ITQ, the

contractor must submit the question(s) via email (with the subject line “ITQ #3510T01 Question”) to the Contracting Officer named in Part II, (B). Questions must be submitted no later than the date indicated in the Calendar of Events. The Contracting Officer shall post as an addendum to this ITQ the answers to the questions on the DGS website by the date stated on the Calendar of Events. Each contractor shall be responsible to monitor the DGS website for new or revised ITQ information.

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PART III

REQUEST FOR QUOTE (RFQ) PROCESS The second step in the procurement process involves the issuance of Requests for Quotes (RFQ) to Qualified Contractors. All contractors who meet the requirements for qualification under this ITQ shall be placed on a Qualified Contractors list in each of the counties where they indicated an interest in performing work. PennDOT Purchasing Offices shall send Request for Quotes (RFQs) to contractors listed on their county’s Qualified Contractors list. (Refer to Exhibit F, “Sample - Request for Quote”).

Contractors should respond to each RFQ, even if only checking the box on the RFQ to indicate that they shall not be submitting a quote. The RFQ must be signed in ink by the authorized signatory; it shall be rejected if signed in pencil and/or by a non-authorized individual.

It is the responsibility of each contractor to ensure that its quote is received at the location specified on the RFQ prior to the date and time set for the opening of quotes, regardless of medium used. No quote shall be considered if it arrives at the location specified on the RFQ after the date and time set for opening of the quotes. In the event PennDOT’s offices are officially closed on the date scheduled for the opening of the quotes; due to inclement weather, natural disaster, or other cause, the quote opening date shall be automatically postponed until the next Commonwealth business day, unless the contractors are otherwise notified by PennDOT. The quote opening time shall remain the same.

If a quote is submitted with conditions or exceptions or not in conformance with the terms and conditions referenced in the Invitation to Qualify or the RFQ, it shall be rejected. The quote shall also be rejected if the services offered by the contractor are not in conformance with the specifications as determined by PennDOT. A. Contractor’s Representation and Authorization: By submitting its quote, each

contractor understands, represents and acknowledges that:

i. All of the contractor’s information and representations in the quote are material and important, and the Purchasing Office may rely upon the contents of the quote in awarding the contract(s). The Commonwealth shall treat any misstatement, omission or misrepresentation as fraudulent concealment of the true facts relating to the quote submission, punishable pursuant to 18 Pa. C.S. § 4904.

ii. The contractor has arrived at the price(s) and amounts in its quote independently

and without consultation, communication, or agreement with any other contractor or potential contractor.

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iii. The contractor has not disclosed the price(s), the amount of the quote, nor the approximate price(s) or amount(s) of its quote to any other firm or person who is a contractor or potential contractor for this RFQ, and the contractor shall not disclose any of these items on or before the quote submission deadline specified in the RFQ.

iv. The contractor has not attempted, nor shall it attempt, to induce any firm or person

to refrain from submitting a quote on this RFQ, or to submit a quote higher than this quote, or to submit any intentionally high or noncompetitive quote or other form of complementary quote.

v. The contractor makes its quote in good faith and not pursuant to any agreement or

discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive quote.

vi. To the best knowledge of the person signing the quote for the contractor, the

contractor, its affiliates, subsidiaries, officers, directors, and employees are not currently under investigation by any governmental agency and have not in the last four years been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to quoting or proposing on any public contract, except as the contractor has disclosed in its quote.

vii. To the best of the knowledge of the person signing the quote for the contractor and

except as the contractor has otherwise disclosed in its quote, the contractor has no outstanding, delinquent obligations to the Commonwealth including, but not limited to, any state tax liability not being contested on appeal or other obligation of the contractor that is owed to the Commonwealth.

viii. The contractor is not currently under suspension or debarment by the

Commonwealth, any other state or the federal government, and if the contractor cannot so certify, then it shall submit along with its quote a written explanation of why it cannot make such certification.

ix. The contractor has not made, under separate contract with the Purchasing Office,

any recommendations to the Purchasing Office concerning the need for the services described in its quote or the specifications for the services described in the quote.

x. Each contractor, by submitting its quote, authorizes Commonwealth agencies to

release to the Commonwealth information concerning the contractor's Pennsylvania taxes, unemployment compensation and workers’ compensation liabilities.

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xi. Until the Selected Contractor receives a fully executed and approved written Purchaser Order from the Purchasing Office, there is no legal and valid Purchase Order, in law or in equity, and the contractor shall not begin to perform.

B. Clarification and Additional Information: After the receipt of quotes, PennDOT shall

have the right to contact contractors for the purpose of seeking:

i. Clarification of the quote which confirms PennDOT’s understanding of statements or information in the quote or;

ii. Additional information on the services offered; provided the Request for Quote does

not require the rejection of the quote for failure to include such information.

C. Rejection of Quotes: PennDOT reserves the right to reject any and all quotes and reissue the solicitation; to waive technical defects or any informality in quotes; and, to accept or reject any part of any quotes if the best interests of PennDOT are thereby served.

D. Quote Modification and Withdrawal: i. Prior to Quote Opening. Quotes may be modified or withdrawn by written notice,

or in person, by a Bidder or the bidder’s representative if the requestor’s identity is made known and a receipt for the quote is signed.

ii. After Quote Opening. A bidder is entitled to withdraw an erroneous quote after quote opening provided:

1. The bidder requests relief.

2. The bidder presents credible evidence with the request that the reason for the

lower quote price was a clerical mistake as opposed to a judgment mistake and was actually due to an unintentional arithmetical error or an unintentional omission of a substantial quantity of work, labor, material, or services made directly in the compilation of the quote.

3. The request for relief and supporting evidence must be received by the

Purchasing Office Contract Person within three business days after quote opening, but before award of the contract.

4. The Purchasing Office Contract Person shall not permit a quote withdrawal if the

quote withdrawal would result in the award of the contract on another quote of the same bidder, its partner, or a corporation or business venture owned by or in which the bidder has a substantial interest.

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5. If a bidder is permitted to withdraw its quote, the bidder cannot supply any material or labor or perform any subcontract or other work agreement for the awarded contractor, without the written approval of the Contracting Officer.

6. If a request for withdrawal is denied by the Commonwealth, and the bidder

refuses to enter into a contract or to perform under the contract, the bidder or its surety shall be liable to the Commonwealth for damages.

E. Firm Quote: Except as provided above, a quote may not be modified, withdrawn, or

cancelled by any contractor for a period of sixty (60) days following the time and date designated for quote opening.

F. Award Notification: Unless all quotes are rejected, and except as otherwise provided by law, award shall be made to the lowest responsible and responsive contractor. In cases of discrepancies in prices, the unit price shall be binding unless the unit price is obviously in error and the extended price is obviously correct, in which case the erroneous unit price shall be corrected. The Purchasing Office Contact Person shall issue the awarded contractor (“Selected Contractor”) a Purchase Order which shall serve as the Notice to Proceed. Each approved Purchase Order shall be deemed to incorporate the terms and conditions set forth in this ITQ Contract, in addition to specific requirements identified on the Request for Quote. The Selected Contractor must not begin work until receipt of and the validity start date listed on the Purchase Order. A sample of a Purchase Order is attached as Exhibit G, “Sample - Purchase Order”.

G. Prompt Payment Discounts: Prompt payment discounts shall not be considered in making an award. However, PennDOT shall take advantage of any prompt payment discounts offered by any contractor.

H. Invoicing: The Selected Contractor shall prepare and submit monthly

, an Invoice (reference Exhibit I), Contractor Notification Log (reference Exhibit H), disposal facility delivery receipts, and OS-501, “Confirmation of Services” (reference Exhibit J), as follows:

i. The contractor shall complete and submit to the Purchasing Office listed on the Purchase Order, the OS-501 form, along with Contractor Notification Log and copies of all delivery receipts from the authorized disposal facility for work completed during the previous month.

ii. The contractor shall complete and submit to the “Bill To” address listed on the

Purchase Order, an Invoice along with copies of the Contractor Notification Log and all delivery receipts from the authorized disposal facility for work completed during the previous month.

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1. Do not submit invoices on colored paper (yellow, green, blue, etc.). Please submit on only black and white. Colored paper creates issues when they are imaged and delays the payment process.

2. Please insure that invoices are legible. If paper invoices are ‘barely’ legible,

scanning the invoices makes them less so and delays the payment process.

If an invoice does not contain the minimum information required as listed on the sample invoice (refer to Exhibit I, ‘Sample-Invoice”), the Commonwealth may return the invoice as improper. If the Commonwealth returns an invoice as improper, the time for processing a payment shall be suspended until the Commonwealth receives a correct invoice. The contractor shall not receive payment until the Commonwealth has received a correct invoice. Each invoice shall be itemized with adequate detail and match the line item on the Purchase Order. In no instance shall any payment be made for services to the contractor that are not in accordance with the prices on the Purchase Order, the Contract, updated prices, or any discounts negotiated by the Purchasing Office.

I. Tagging Dead Deer as part of a special study for Chronic Wasting Disease: County Purchasing Offices included in the Pennsylvania Gaming Commission’s (PGC) Chronic Wasting Disease (CWD) study shall include Exhibit C, “Pennsylvania Commission Special Study of Chronic Wasting Disease (CWD)” in their RFQ. The initial study shall be conducted in the following four (4) counties: Franklin, Fulton, Bedford and Somerset, and maybe extended to include additional counties as needed.

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PART IV

APPLICATION REQUIREMENTS Mandatory Requirements: A. Contractors must have a SAP Vendor Number to do business with the Commonwealth.

The vendor registration form and vendor information is available via the internet at www.vendorregistration.state.pa.us.

B. Contractor’s application package must include the following to be considered responsive and responsible:

i. Completed ITQ Signature Page with an ORIGINAL SIGNATURE of an official of

your company to bind your company to its provisions and the provisions of this ITQ. If signature authority has been delegated, a copy of the delegation, signed by the required principal delegating that authority to the specified individual, must be provided prior to the execution of the contract.

ii. Completed Exhibit D, “Location Sheet” indicating one or more counties in which you are interested in providing Road-Killed Deer Removal and Disposal services.

iii. Legible copy of all contractor vehicle operators’ valid drivers’ licenses.

iv. Legible copy of the valid vehicle registration card(s) for the vehicle(s) that shall be used for removal and disposal of road-killed deer.

v. Legible copy of the valid vehicle insurance card(s) for vehicle(s) that shall be used for removal and disposal of road-killed deer.

vi. Copy of Worker’s Compensation, and Public Liability and Property Damage

Insurance certificate(s) with the Commonwealth listed as additional insured. vii. If including subcontractor(s), submit participating subcontractor’s valid driver’s

license(s), vehicle registration card(s), and vehicle insurance card(s).

Contractor’s submitted responses must be completed on the documents provided. With the exception of the contractor’s signature that must

be in ink, all other required information must be printed legibly in ink or typed.

The contractor must initial and date any errors made while completing information. Any modifications to this ITQ other than information specifically required by PennDOT may be interpreted as a contractor proposing additional or conflicting terms and conditions to the ITQ Application (which may cause the ITQ Application to be rejected by the PennDOT).

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All required documentation submitted in response to the Initial Application Period or Open Enrollment, as listed on the Calendar of Events, shall be included as part of the executed Contract. Final Contract execution cannot occur until the parties sign and acknowledge a complete package as described above. Therefore, any missing information shall result in delays in Contract execution. PennDOT reserves the right to retain any partial information submitted by the contractor and notify the contractor of any omissions. A copy of all documents should be made for your records. C. Evaluation of Applications: A contractor’s noncompliance with any of the mandatory

requirements above shall result in the contractor being considered non-responsive and the submission may be disqualified. Applications considered responsive shall then be evaluated to determine contractor’s qualifications to perform the service based on the documentation submitted as listed above in Part IV, Section B.

D. Award of Contract: All contractors that are found responsive and responsible shall be deemed “qualified”, receive a signed Contract, and be eligible to receive Request for Quotes. This does not guarantee that the contractor’s services shall be used.

If contractor is deemed “not qualified”, PennDOT shall notify the contractor by letter.

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Signature Page PENNSYLVANIA DEPARTMENT OF TRANSPORTATION

ITQ # 3510T01, “Road-Killed Deer Removal and Disposal”

(Complete in INK or TYPE only – DO NOT use pencil)

CONTRACTOR MUST

COMPLETE ALL APPLICABLE AREAS

CONTRACTOR NAME AND ADDRESS If SOLE PROPRIETOR is doing business as (d/b/a) or trading as (t/a)

another name, indicate such. Example John Brown d/b/a or t/a Brown’s Deer Removal and Disposal)

_________________________________________ _________________________________________ _________________________________________

SAP VENDOR #:

PHONE NUMBER: ( )

FAX NUMBER: ( )

E-MAIL ADDRESS:

Are you a MBE/WBE certified by PennDOT? Yes No

If yes, Certification Number:

In compliance with the Invitation to Qualify (ITQ) and subject to Exhibit B “Special Contract Terms and Conditions”, Exhibit A, “Contract Terms and Conditions (STD 274)” and any documents attached to the ITQ or incorporated by reference, the undersigned offers and agrees, if this application is accepted, to furnish any and all services upon which it receives orders. The undersigned acknowledges that the representations made in this application are material and important and shall be relied upon by the Commonwealth in awarding the Contract(s) for which the application is submitted. Any misstatement in this application is, and shall be treated as, fraudulent concealment from the Commonwealth of the facts relating to the submission of this application.

CONTRACTOR’S SIGNATURE, DATE AND TITLE (required in INK) CORPORATIONSr. Vice President, Exec. Vice President, Asst. Vice President,

: Chairman, President, Vice President,

CEO or CFO. Any other signature must be accompanied by a resolution authorizing the individual to contractually bind the organization.: X ______________________________________________________ ________________ ______________________________ SIGNATURE DATE TITLE SOLE PROPRIETORSHIP

OWNER ONLY: X ______________________________________________________ ________________ ______________________________ :

SIGNATURE DATE TITLE

ONE GENERAL PARTNER ONLY: X ______________________________________________________ ________________ ______________________________ PARTNERSHIP:

SIGNATURE DATE TITLE LIMITED LIABILITY CO

MEMBER OR MANAGER: X ______________________________________________________ ________________ ______________________________ .

SIGNATURE DATE TITLE

FOR COMMONWEALTH USE ONLY 1. AGENCY HEAD OR DESIGNEE

X____________________________ ___________ SIGNATURE DATE

4. GENERAL COUNSEL (Approved as to Legality and Form)

X___________________________ _____________ SIGNATURE DATE

2. PENNDOT OFFICE OF CHIEF COUNSEL (Approved as to Legality and Form)

X____________________________ ___________ SIGNATURE DATE

5. ATTORNEY GENERAL (Approved as to Legality and Form)

X___________________________ _____________ SIGNATURE DATE

3. OFFICE OF THE COMPTROLLER (Approved as to Fiscal Responsibility, Budgetary Appropriateness and Availability of Funds)

X_____________________________ __________ SIGNATURE DATE

CONTRACT EXECUTION DATE:

TAX ID# (FIN or SSN):

CONTRACTOR CONTACT PERSON:

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EXHIBIT A

STANDARD CONTRACT TERMS

AND CONDITIONS (STD 274)

The link to the Standard Contract Terms and Conditions (STD 274) is indicated below:

http://www.dgsweb.state.pa.us/comod/CurrentForms/STD274_SAP.doc

EXHIBIT B

SPECIAL CONTRACT TERMS AND CONDITIONS

EXHIBIT B

SPECIAL CONTRACT TERMS AND CONDITIONS

ITQ #3510T01, “Road-Killed Deer Removal and Disposal” A. Term of the Contract: The term of the Contract shall commence on the effective date

of the Notice–to-Proceed and shall end on June 30, 2016

, subject to other provisions of the Contract. A contractor shall not perform any work until a Contract has been fully executed, and a Request for Quote (RFQ) has been issued and awarded through a fully executed Purchase Order to the contractor by PennDOT.

This Contract, when accepted by PennDOT, shall constitute a Contract that is binding on the contractor, his/her executors, administrators, successors, and/or assignees. Although the term of this Contract extends to June 30, 2016, issuance of a Purchase Order for a shorter period of time does not mean that a contractor is entitled to work above and beyond the effective dates of any Purchase Order which is issued under a RFQ. Nothing contained in this Contract shall be construed so as to supersede the Game & Wildlife Code.

B. Changes Affecting the Status of the Contract: It is the responsibility of the contractor to notify the Contracting Officer in writing of any changes that affect the status of the Contract including, but not limited to: a. Change in vehicle or operator status (e.g., insurance, registration, operator driver’s

license and/or contractor availability); b. Equipment unavailability or breakdown; c. Selection of different disposal facility or issues at facility; and, d. Any issue which may negatively affect the performance of the service.

Refer to Exhibit A, “Standard Contract Terms and Conditions, Paragraph #21 & Paragraph #24” for additional requirements.

C. Existing Contracts: All existing contracts for this service may continue until the end of

their current term, in accordance with the terms and conditions of the existing Contract. D. Procurement of Alternate Services: PennDOT reserves the right to procure services

under this Contract through another source, where PennDOT concludes that it is in the Commonwealth’s best interest to do so. PennDOT reserves the right to conduct work with its own workforce.

E. Prime Contractor Responsibilities: Each contractor who is successfully qualified shall

be considered a prime contractor with respect to PennDOT’s Road-Killed Deer Removal and Disposal services Contract. Each Selected Contractor shall be required to assume

responsibility for delivery of all services specified. Further, PennDOT shall consider the Selected Contractor to be sole point of contact with regard to contractual matters, including payment of any and all charges.

F. Insurance: Prior to qualification for work under the Contract and at each insurance

renewal date during the term of the Contract, the contractor shall provide the Contracting Officer with copies of current certificates of insurance. These certificates or policies shall name the Commonwealth as an additional insured and shall contain a provision that the coverage’s afforded under the policies shall not be cancelled or changed until at least thirty (30) days’ written notice has been given to PennDOT, except for fifteen (15) days’ written notice for nonpayment of premium.

PennDOT shall be under no obligation to obtain such certificates from the contractor. Failure by PennDOT to obtain the certificates shall not be deemed a waiver of the contractor’s obligation to obtain and furnish certificates. PennDOT shall have the right to inspect the original insurance policies. The contractor is required to have in place during the term of the Contract and any renewals or extensions thereof, the following types of insurance, issued by companies acceptable to PennDOT and authorized to conduct such business under the laws of the Commonwealth of Pennsylvania:

a. Worker's Compensation Insurance for all of the contractor's employees and those of any subcontractor, engaged in work at the site of the project as required by law.

b. Public Liability and Property Damage Insurance to protect the

Commonwealth, the contractor, and any and all subcontractors from claims for damages for personal injury (including bodily injury), sickness or disease, accidental death and damage to property including the loss of use resulting from any property damage, which may arise from the activities performed under the Contract or the failure to perform under the Contract, whether such performance or non-performance be by the contractor, by any subcontractor, or by anyone directly or indirectly employed by either. The minimum amounts of coverage shall be $250,000 per person and $1,000,000 per occurrence for bodily injury, including death, and $250,000 per person and $1,000,000 per occurrence for property damage. Such policies shall be occurrence rather than claims-made policies and shall not contain any endorsements or any other form designated to limit and restrict any action by the Commonwealth, as an additional insured, against the insurance coverage in regard to work performed for the Commonwealth.

c. State Minimum Auto Insurance for all vehicles intended for use in this

Contract.

G. Permits, Fees and Notices: The contractor shall obtain and pay for all permits, licenses, and certifications required by law for proper execution and completion of its work. The contractor shall furnish proof of payment for permits, licenses or certificates, or proof

that no permits, licenses or certificates are required. This proof must be furnished prior to starting work.

The contractor shall give all notices and comply with all applicable laws, ordinances, regulations, rules and orders of any public authority bearing on the performance of the work. If the contractor observes that any of the Contract documents are at variance therewith in any respect, it shall promptly notify the Issuing Office, in writing. Any necessary modifications shall be made by the Issuing Office.

If the contractor performs any work knowing it to be contrary to such applicable laws, ordinances regulations, rule of orders, and without such written notice to the Issuing Office, it assumes full responsibility therefore and shall bear all cost attributable thereto.

H. Contractor Performance: During the Contract period, contractors who perform poor or

unsafe work, do not provide services on time, or engage in other unacceptable conduct (i.e. violation of Contract terms and conditions), may be entered into the Commonwealth’s Contractor Responsibility Program (CRP), and may be removed from the list of Qualified Contractors and be restricted from performing Road-Killed Deer Removal and Disposal services. Furthermore, entry into the CRP may affect the contractor’s ability to obtain future contracts with all Commonwealth agencies.

I. Order of Precedence: If any conflicts or discrepancies should arise in the terms and

conditions of this Contract, or the interpretation thereof, the order or precedence shall be:

a. The Contract, subject to its internal order of precedence as follows: (1) Exhibit B, “Special Contract Terms and Conditions”; (2) Exhibit A, “Standard Terms and Conditions”; and (3) all other documents referenced in this ITQ.

b. Purchase Order and any attachments thereto, including: (1) the Contractor’s quote as accepted by the Commonwealth; and (2) the RFQ.

J. Protests: Any protest arising from the award or non-award of a Contract by PennDOT

as a result of this ITQ (or subsequently issued RFQ) must be filed in writing with the Secretary of the Department of Transportation and follow the procedures set forth in Section 1711.1 of the Procurement Code, 62 Pa.C.S. § 1711.1.

K. News Releases: Contractors shall not issue news releases, internet postings,

advertisements or any other public communications pertaining to this Project without written approval of the Issuing Office, and then only in coordination with the Issuing Office.

L. Ride-Along Procedure: All requests to accompany drivers performing Road-Killed

Deer Removal and Disposal services must be sent to the Contracting Officer for review and to obtain the proper PennDOT approvals prior to allowing access to vehicles and staff.

M. Disadvantaged Business Information: The Issuing Office encourages participation by small disadvantaged businesses as prime contractors, joint ventures and subcontractors/suppliers and by socially disadvantaged businesses as prime contractors.

Small Disadvantaged Businesses are small businesses that are owned or controlled by a majority of persons, not limited to members of minority groups, who have been deprived of the opportunity to develop and maintain a competitive position in the economy because of social disadvantages. The term includes:

a. Department of General Services Bureau of Minority and Women Business Opportunities (BMWBO)-certified minority business enterprises (MBEs) and women business enterprises (WBEs) that qualify as small businesses; and

b. United States Small Business Administration certified 8(a) small disadvantaged

business concerns.

c. Businesses that BMWBO determines meet the Small Business Administration criteria for designation as a small disadvantaged business.

Small businesses are businesses in the United States which are independently owned, are not dominant in their field of operation, employ no more than 100 full-time or full-time equivalent employees, and earn less than $20 million in gross annual revenues ($25 million in gross annual revenues for those businesses in the information technology sales or service business). Socially disadvantaged businesses are businesses in the United States that BMWBO determines are owned or controlled by a majority of persons, not limited to members of minority groups, who are subject to racial or ethnic prejudice or cultural bias, but which do not qualify as small businesses. In order for a business to qualify as “socially disadvantaged,” the contractor must include in its application clear and convincing evidence to establish that the business has personally suffered racial or ethnic prejudice or cultural bias stemming from the business person’s color, ethnic origin or gender. Questions regarding this Program can be directed to:

Department of General Services Bureau of Minority and Women Business Opportunities Room 611, North Office Building Harrisburg, PA 17125 Phone: (717) 783-3119 Fax: (717) 787-7052 Email: gs-bmwbo@state.pa.us Website: www.dgs.state.pa.us

A database of BMWBO-certified minority- and women-owned businesses can be accessed at http://www.dgsweb.state.pa.us/mbewbe/VendorSearch.aspx. The federal vendor database can be accessed at http://www.ccr.gov by clicking on Dynamic Small Business Search (certified companies are so indicated).

N. Information Concerning Small Businesses in Enterprise Zones: The Issuing Office encourages participation by small businesses, whose primary or headquarters facility is physically located in areas the Commonwealth has identified as Designated Enterprise Zones, as prime contractors, joint ventures and subcontractors/suppliers. The definition of headquarters includes, but is not limited to, an office or location that is the administrative center of a business or enterprise where most of the important functions of the business are conducted or concentrated and location where employees are conducting the business of the company on a regular and routine basis so as to contribute to the economic development of the geographical area in which the office or business is geographically located. Small businesses are businesses in the United States which are independently owned, are not dominant in their field of operation, employ no more than 100 full-time or full-time equivalent employees, and earn less than $20 million in gross annual revenues ($25 million in gross annual revenues for those businesses in the information technology sales or service business). There is no database or directory of small businesses located in Designated Enterprise Zones. Information on the location of Designated Enterprise Zones can be obtained by contacting:

Aldona M. Kartorie Center for Community Building PA Department of Community and Economic Development 4th Floor, Commonwealth Keystone Building 400 North Street Harrisburg, PA 17120-0225 Phone: (717) 720-7409 Fax: (717) 787-4088 Email: akartorie@state.pa.us

O. Lost Profits: In the event of termination of a Purchase Order or Contract, the contractor shall not be entitled to lost profits or any payments beyond the payments due for work satisfactorily completed. This prohibition shall apply to instances of termination for cause, non-appropriation, or convenience.

P. Notice: Any written notice to any party under this Contract shall be deemed sufficient if delivered personally, or by facsimile, telecopy, electronic or digital transmission (provided such delivery is confirmed), or by a recognized overnight courier service (e.g., DHL, Federal Express, etc.) with confirmed receipt, or by certified or registered United States mail, postage prepaid, return receipt requested, and sent to following: a. If to the contractor – the contractor’s address as recorded in the Commonwealth’s

Supplier Registration system. b. If to PennDOT – the address for the Issuing Office as set forth on this ITQ in the

Calendar of Events.

EXHIBIT C

PENNSYLVANIA GAME COMMISION SPECIAL

STUDY OF CHRONIC WASTING DISEASE

EXHIBIT C

PENNSYLVANIA GAME COMMISSION SPECIAL STUDY OF CHRONIC WASTING DISEASE (CWD)

ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

According to the Pennsylvania Department of Natural Resources Wildlife Resources, Chronic Wasting Disease (CWD) is a neurological (brain and nervous system) disease of deer and elk known to occur in limited geographical locations in North America. The disease belongs to the family of diseases known as Transmissible Spongiform Encephalopathies (TSE). These diseases are caused by an abnormal form of a protein called prion. CWD is a slow accumulation of abnormal prions in the brain and lymphatic tissues of deer and elk that ultimately result in the death of the animal. In deer and elk there is no practical test of live animals to detect CWD and there is no known treatment or vaccine. This disease can be spread both directly (animal to animal contact) and indirectly (soil or other surface to animal). There currently is no convincing evidence that the agent of CWD affects humans. However, public health officials recommend that people do not eat meat from known infected animals, or animals that appear sick.

Background

Process

This deadly disease has last been reported only ten (10) miles from the Pennsylvania border in Maryland. In order to monitor and track the movement of this disease the Pennsylvania Game Commission (PGC) and PennDOT, in a joint venture, shall start sampling road killed deer picked up by contractors and PennDOT personnel. The first four (4) counties to start testing shall be: Franklin, Fulton, Bedford and Somerset Counties. These counties were chosen as they are closest to deer reported to be infected in Maryland. PennDOT and PGC shall determine if other counties need to be added to the study. Sampling for CWD shall take place yearly from October 1 through April 30 during this entire ITQ period. Beginning and end dates maybe changed as the situation warrants based on results from samples taken, or other relevant information provided to the PGC. This program shall be administered through the interaction and cooperation of PennDOT District Counties and the PGC.

Tasks

i. E-mail assigned PGC Representative’s contact information, for the counties currently designated for deer testing, to Nadine Chinapoo, PennDOT Contracting Officer at

Pennsylvania Game Commission (PGC) shall:

nchinapoo@state.pa.us. ii. Notify Contracting Officer of changes or additions of counties and PGC Representatives,

as needed. iii. Ship deer tags to District County Offices participating in CWD study.

Contracting Officer shalli. E-mail PennDOT District Purchasing Office PGC Representative(s) contact information

and any changes to counties participating, as needed.

:

i. Act as liaison to provide contractor and PGC Representative with each other’s contact information.

The Purchasing Office Contact Person shall:

ii. Distribute deer tags to contractors participating in the CWD study.

i. Contact their selected and approved disposal facility to secure a designated staging area for the deer testing.

The Contractor shall:

ii. Contact the PGC Representative and inform him/her of disposal site and designated staging area for deer testing.

iii. Complete a tag provided by the Game Commission and attach it to the ear of each adult deer picked up.

iv. Contact PGC Representative immediately after pick-up of dead deer and arrange to meet at designated disposal facility staging area. This notification requirement shall not conflict with any disposal requirements in PART I, Section IV-Tasks, C, “Disposal”.

a. If PGC Representative is unable to meet on the suggested day or time, proceed with normal disposal of deer at facility.

b. If after waiting at site a half hour after agreed upon meeting time, the PGC Representative does not arrive or call, proceed with normal disposal of deer at facility.

v. Proceed with normal disposal of deer at the facility after PGC Representative has completed taking samples from the tagged deer (this shall take approximately 2-5 min. per animal).

i. Coordinate meeting time and location at disposal facility with contractor. The PGC Representative shall:

ii. Meet contractor at designated staging area at disposal facility within half hour of agreed upon time.

a. If anticipating a delayed arrival, contact contractor immediately to arrange for alternative time or cancel meeting.

iii. Obtain deer pick-up location information on tag, and take samples from tagged deer.

EXHIBIT D

LOCATION SHEET

EXHIBIT D

Location Sheet

ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

To be completed and submitted with ITQ Application

Instructions: Indicate by an “X”, the county (ies) in which you intend to perform service. A map showing the location of each of the counties is included for your reference. Only after an ITQ contract has been awarded and fully executed, can a contractor change the counties in which she/he wishes to perform services. The contractor shall submit the requested change(s) in writing to the ITQ Contracting Officer. The change(s) must be approved by PennDOT and shall be effective upon issuance of an acceptance letter by PennDOT.

Contractor Name:__________________________________ FIN/SSN:________________________ SAP Vendor#_______________

Place an X in box beside county where you wish to supply Road Killed Deer Removal & Disposal Services.

County Name X County Name X County Name X Adams Elk Montgomery

Allegheny Erie Montour Armstrong Fayette Northampton

Beaver Forest Northumberland Bedford Franklin Perry Berks Fulton Philadelphia Blair Greene Pike

Bradford Huntingdon Potter Bucks Indiana Schuylkill Butler Jefferson Snyder

Cambria Juniata Somerset Cameron Lackawanna Sullivan Carbon Lancaster Susquehanna Centre Lawrence Tioga Chester Lebanon Union Clarion Lehigh Venango

Clearfield Luzerne Warren Clinton Lycoming Washington

Columbia McKean Wayne Crawford Mercer Westmoreland

Cumberland Mifflin Wyoming Dauphin Monroe York Delaware

EXHIBIT E

SAMPLE - DISPOSAL SITES

EXHIBIT E - SAMPLE

DISPOSAL SITES

ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

To be completed and submitted with response to Request for Quote (RFQ)

Instructions: Log on to the current listing of Municipal Waste Disposal Facilities at http://www.portal.state.pa.us/portal/server.pt?open=514&objID=589660&mode=2. Select disposal site you intend to use for road-killed deer disposal and call to confirm if site accepts deer carcasses. If yes, type or print in ink location name and address below. If using a site not listed on the Municipal Waste Disposal Facilities website, the alternative site must be approved by the Bureau of Land Recycling and Waste Management, Department of Environmental Protection (DEP) and must be accompanied by an approval letter from DEP. For approval, call (717) 787-9871. Any proposed disposal site may be subject to the inspection of DEP as part of the approval process. PennDOT reserves the right to require the contractor to utilize an alternate disposal facility if it is in the best interest of the Commonwealth to do so.

Contractor Name: __________________________________ FIN/SSN:________________________ SAP Vendor #_____________

PRIMARY DISPOSAL SITE: County: ______________________________________________________________________ Method of disposal: ____________________________________________________________ Facility Name: _________________________________________________________________ Address: ______________________________________________________________________ _____________________________________________________________________________ Phone #_______________________________________________________________________ ADDITIONAL DISPOSAL SITE: County: ______________________________________________________________________ Method of disposal: ____________________________________________________________ Facility Name: _________________________________________________________________ Address: ______________________________________________________________________ _____________________________________________________________________________ Phone #_______________________________________________________________________

EXHIBIT F

SAMPLE – REQUEST FOR QUOTE

EXHIBIT F - SAMPLE

REQUEST FOR QUOTE (RFQ) ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

Date RFQ Sent: ________________________ County: _________________________ Completed RFQ Due: ________________ AM/PM on: ____________________________ Quote Opening: ________________ AM/PM on: ____________________________ You have been identified as a Qualified Contractor for this county’s Road-Killed Deer Removal and Disposal services. Please complete the information below and return it to the address at the bottom of this form. The form MUST be received no later than the date and time shown above. Opening of the quotes received by the deadline shall take place at the date and time shown above. If you are the lowest responsive and responsible bidder, you shall receive a Purchase Order as your Notice to Proceed. DO NOT

respond to request to remove and dispose of road-killed deer until the Validity Start Date shown on the Purchase Order.

DO NOT

respond to request to remove and dispose of road-killed deer unless you receive a Purchase Order.

Routes to Service: _______________________________________________________________________________ Contractor Name (as it appears on your Contract): _____________________________________________________________ SAP Vendor #: ______________________________________ Contract #: ___________________________________________ If bidding on this project, complete Cost Submittal information and return form to address below: COST SUBMITTAL: Pick-up cost per deer: _________________________________________ Disposal cost per deer: _________________________________________ Total cost per deer (pickup + disposal):___________________________

(NOTE: Call-out cost shall be 50% of Total cost per deer.) If not bidding on this project, check box and return form to address below: ------------------------------------------------------------------------------------------------------------------------------------------------------------------- I understand that the above price would be in effect only for the period shown on the Purchase Order if selected as the lowest responsive and responsible bidder. Contractor’s Signature (ink): ____________________________________________________________ Date: _________________ Contractor’s Title: _____________________________________________________________________

MUST BE SIGNED BY CONTRACTOR’S AUTHORIZED SIGNATORY

Attach completed Disposal Sites form to RFQ response and submit to:

PA Department of Transportation

ATTN:

EXHIBIT G

SAMPLE – PURCHASE ORDER

SAMPLE – PURCHASE ORDER

EXHIBIT H

SAMPLE - CONTRACTOR NOTIFICATION LOG

EXHIBIT H - SAMPLE

Contractor Notification Log

ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

To be completed and submitted each month with OS-501 Form to Purchasing Office.

Instructions: Complete all required information below for each service call. If dead deer is located prior to receiving notification from PennDOT, call PennDOT for approval to pick up. If given approval by PennDOT to pick up and dispose of dead deer, list name of person authorizing pick-up and the date and time of approval.

Contractor name: ____________________________________________ SAP Vendor # ___________________ Purchase Order #:______________________ Service Month: __________________ Date Submitted:__________

Date Time # of Deer Picked

Up (Indicate call-out only with ‘0’)

Deer Location Deer Pick-up Authorized by: (Name)

Page 1 of __________

Contractor Name: _________________________________________________ Date Submitted: _________________

Date Time # of Deer Picked Up (Indicate call-out only with ‘0’)

Deer Location Deer Pick-up Authorized by: (Name)

Page _____ of ______

EXHIBIT I - SAMPLE

INVOICE

EXHIBIT I – SAMPLE

ITQ #3510T01, “Road-Killed Deer Removal and Disposal”

INVOICE

REMIT TO: Contractor Name Street Address City, State, Zip Contact Person: Phone: (123) 456-7890 Fax: (234) 567-8901 Email:

Invoice #: 000001 Invoice Date: February 10, 2011 Service Month: January, 2011 Purchase Order #: 430000000 Contract #: 44000000000 SAP Vendor #:

BILL TO ADDRESS: Commonwealth of Pennsylvania – PO Invoice PO Box 69180 Harrisburg, PA 17108

PENNDOT PURCHASING OFFICE ADDRESS: Office Name Street Address City, PA, Zip

COMMENTS:

P.O. Line Item #

Description Quantity Unit Price Total Price

1 Deer Pick-up & Disposal 2 Call- out (no deer removed)

TOTAL DUE

Signature: ___________________________________________________ Date: __________________ (MUST BE SIGNED BY CONTRACTOR’S AUTHORIZED SIGNATORY)

CONTRACTOR:

Make sure your company’s mailing address is the same as the one on you registered with Central Vendor Management when you obtained your SAP Vendor Number. Discrepancies can delay payment. Complete this invoice completely, making sure that the Summary of this month’s services quantities on the Invoice and the OS-501 “Confirmation of Services” are entered and are an exact match.

Contractor Notification Log Invoice includes:

Disposal Receipts

EXHIBIT J

SAMPLE – CONFIRMATION OF SERVICES

The link to the OS-501, “Confirmation of Services Form” is indicated below:

ftp://ftp.dot.state.pa.us/public/PubsForms/Forms/OS-501.pdf