FORM 3 pg 1 of 1 Rev. 8/9/12 STATE OF NEW JERSEY BID # 13

FORM 3
pg 1 of 1
STATE OF NEW JERSEY
DEPARTMENT of TRANSPORTAION
BID # 13-X-22837
Bid Opening Date: 10/11/12
SNOW REMOVAL QUESTIONAIRE – VENDOR INFORMATION FORM: RENTAL of GRADERS & LOADERS W/ OPERATOR
(OWNED OR LEASED BY VENDOR)
August 1, 20____ to July 31, 20 ____
(TYPE OR PRINT)
Vendor – Name and Business Address:
Telephone Number:
Day:
Home Address:
Night:
Telephone Number:
Day:
Night:
Superintendent – Name and Address:
Telephone Number:
Name and Location Where Vendor’s Trucks Will Be Stored:
Telephone Number:
Day:
Night:
Cellular:
Vendor’s Federal I.D. Number:
FURNISH THE FOLLOWING INFORMATION FOR EQUIPMENT TO BE USED ON THIS CONTRACT
MAKE
YEAR
MODEL
LICENSE
PLATE
NUMBER
CLASS “C”
GRADER
CLASS “D”
GRADER
CLASS
“E”
LOADER
CLASS
“F”
LOADER
CLASS
“G”
LOADER
CLASS
“H”
LOADER
CLASS
“I”
LOADER
CLASS
“J”
LOADER
CLASS
“K”
LOADER
IF NOT VENDOR OWNED
CHECK & ATTACH
FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
CHECK HERE __________ATTACH FORM 2
Vendor Name ( please print ): _________________________________________________________________________________________________________
Vendor Signature:
________________________________________________________________ Date: ______________________________________
(Attach Additional Sheets as Necessary)
Rev. 8/9/12