R & C STRUCTURES, INC.

1615 LA MIRADA DR. SAN MARCOS, CA 92069 (PRINT FORM AND MAIL OR FAX) 760.744.0478

REQUEST FOR QUOTE FORM

PROJECT NAME:______________________________________________________________________________________________________________

JOB SITE ADDRESS:________________________________________________________T.B. PAGE:_________________________________________

BID DATE:__________________ESTIMATED START DATE________________________DISTRICT:_______________________________________

CITY:____________________________________#OF M.H.'S:__________________________________________________________________________

AVERAGE DEPTH:_________________________PIPE SIZE:___________________________________________________________________________

#OF M.H.'S PER TRIP:__________________________________________________________________________________________________________

M.H. TYPE (I.E.S.-17 OR S-2)__________________________________REG. OR T-LOCK___________________________________________________

LOCKING RINGS & COVERS: YES OR NO if yes how many__________________________________________________________________________

LEAVE M.H.'S 6"-9" LOW: YES OR NO / GROUND WATER YES OR NO

ANY WRAP-UP INSURANCE: YES OR NO / PREVAILING WAGE JOB: YES OR NO / BUY AMERICA PROJECT (USA): YES OR NO

ANYTHING SPECIAL THAT MAY BE REQUIRED, THAT IS NOT ON THIS FORM

PLEASE LIST._________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

IF REQUIRED SHOULD WE INCLUDE THE FOLLOWING

T-LOCK WELDING: YES OR NO VACUUM TESTING: YES OR NO

SAN-CON 100 POLYURETHANE INTERIOR COATING: YES OR NO

EXTERIOR COATINGS ARE EXCLUDED

NIGHT WORK WILL BE EXCLUDED UNLESS OTHERWISE STATED ABOVE.

CONTRACTOR'S NAME:______________________________________________________________________________________________________

CONTRACTOR'S PH. #____________________FAX #__________________ESTIMATORS NAME:__________________

DATE OF REQUEST:_________________CONTRACTOR'S EMAIL ADDRESS:________________________

ENTIRE FORM MUST BE FILLED OUT AND RETURNED, BEFORE PROJECT IS QUOTED.