Part II: Bid, Scope of Work and Contract Form This document is a Bid Form and Construction Contract (the made effective this day “Contract”) of , 20 , between (the "Homeowner"), for work to be performed at (the or and (the having a principal place of business at . “Premises” “home”) “Contractor”) Narrative description of work scope: If the project includes any electrical work, list the current electrical circuit load capacity (i.e. home’s 200 AMPS) Please describe how the electrical will be effected by the work scope: Required Permits (please check all that apply) Electrical Plumbing Gas Building (if the town/city requires plans, please include) The first 7 pages of this form are required for all HMLP funded projects. The remaining pages are divided into sub forms by type of modification. Please complete the forms which pertain to the project. Please check all sub forms which apply to this project & will be included with the HMLP Bid, Scope of Work and Contract Form Form A: Ramps, lifts or Elevators Form B: Exterior Modifications Form C: Bathroom Modifications (duplicate form for any work performed in a second bathroom) Kitchen/Landry Modifications Form D: Form E: Permanent Adaptive Design TOTAL PROJECT COSTS (Subcontractor, Materials, Labor) Work Item Total Cost Form A Ramps, Lifts or Elevators $0.00 Form B Exterior Modifications $0.00 Form C Bathroom Modifications $0.00 Form D Kitchen/Laundry $0.00 Form E Permanent Adaptive Design $0.00 Permit(s) Disposal/Dumpster Total Project Cost $ 0.00 TOTAL COST COVERED BY HMLP (not to exceed $30,000): ADDITIONAL ITEMS Please provide the hourly labor rate for any additional work that may be required/requested.
Part II: Bid, Scope of Work and Contract Form This document is a Bid Form and Construction Contract (the “Contract”) made effective this day of , 20 , between (the "Homeowner"), for work to be performed at (the “Premises” or “home”) and (the “Contractor”) having a principal place of business at . Narrative description of work scope: If the project includes any electrical work, list the home’s current electrical circuit load capacity (i.e. 200 AMPS) Please describe how the electrical will be effected by the work scope: Required Permits (please check all that apply) Electrical Plumbing Gas Building (if the town/city requires plans, please include) The first 7 pages of this form are required for all HMLP funded projects. The remaining pages are divided into sub forms by type of modification. Please complete the forms which pertain to the project. Please check all sub forms which apply to this project & will be included with the HMLP Bid, Scope of Work and Contract Form Form A: Ramps, lifts or Elevators Form B: Exterior Modifications Form C: Bathroom Modifications (duplicate form for any work performed in a second bathroom) Form D: Kitchen/Landry Modifications Form E: Permanent Adaptive Design TOTAL PROJECT COSTS (Subcontractor, Materials, Labor) Work Item Total Cost Form A Ramps, Lifts or Elevators $0.00 Form B Exterior Modifications $0.00 Form C Bathroom Modifications $0.00 Form D Kitchen/Laundry $0.00 Form E Permanent Adaptive Design $0.00 Permit(s) Disposal/Dumpster Total Project Cost $ 0.00 TOTAL COST COVERED BY HMLP (not to exceed $30,000): ADDITIONAL ITEMS Please provide the hourly labor rate for any additional work that may be required/requested.