Section 1 – General Information
PORFP Number: (ADPICS PO Number)
PORFP Type:
Functional Area (FA) for this PORFP:	FA I (Structured Cable Wiring )
Designated Small Business Reserve?(SBR): (Select “Yes” or “No” from drop down list)
PORFP Issue Date: (mm/dd/yyyy)	PROPOSAL DUE DATE and TIME:
Special Instructions:
Invoicing Instructions:
Section 2 – Agency Point of Contact (POC) Information
Agency / Division Name:
Agency POC Name:	Agency POC Phone Number:
Agency POC Email Address:	Agency POC Fax:
Agency POC Mailing Address:
Section 3 – Delivery Address POC Information (if different from above)
Agency On-site Contact Name:	Agency On-site Phone Number:
Agency On-site Email Address:	Agency On-site Fax:
Agency On-site Address:
Section 4 – Scope of Work
FA I – Structured Cable and Wiring (Provide itemized list of required information and model number/s. If type of equipment is unknown, describe required functionality):
List Required Cable and Wiring Materials, Equipment and Model Number/s	Quantity
<insert item> <insert item> <add / delete bullets as needed>	<insert item> <insert item> <add / delete bullets>
Due Date for Delivery: (mm/dd/yyyy)
FA II – Installation, Relocation, Preventive and Routine Maintenance of Outside Plant Fiber Optic and Communications Cables (Provide itemized list of required installation services. If type of equipment is unknown, describe required functionality):
List Required Cable and Wiring Installation	Quantity
1. <insert item> 2. <insert item> 3. <add / delete bullets as needed. Note: Use CTRL+TAB to insert a tab inside this text>	1. <insert item> 2. <insert item> 3. <insert item>
Work Start Date: (mm/dd/yyyy)
Work End Date: (mm/dd/yyyy)
Section 5 – Evaluation Criteria – Technical Proposal (Provide a list of evaluation criteria in descending order of importance)
1. <insert item> 2. <insert item> 3. <add / delete bullets as needed>
Basis for Award Recommendation Evaluation criteria for award will be established at the PORFP level. The agency POC will recommend award to the Master Contractor whose proposal is determined to be the most advantageous to the State, considering price and the evaluation factors set forth in the PORFP. The agency POC will initiate and deliver a PO to the selected Master Contractor.