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STATE OF CONNECTICUT

BID ADDENDUM
UCHC-18 Rev. 12/04
Jennifer Kelley
Purchasing Services Officer

UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Administrative Services Building 1st Floor
263 Farmington Avenue
Farmington CT 06032

Bid Number:

4-1599
Bid Due Date:

October 13, 2006

860-679-2408
Telephone Number

Bid Addendum #1
DESCRIPTION: Backflow Device Testing for the University of Connecticut Health Center
Bidders Note:
Please include the following response to bidders’ questions in your bid specifications:
Questions:
A. Is it possible to find out what the previous contractor was charging for its contract
B. Can you provide a list of all Backflow Preventers to be tested by size, make, model number and
location?
Response:
A:
Device Size
½”
¾”
1”
1¼”
1½”
2”
3”
4”
6”

Testing Unit Price
$27.50
$27.50
$27.50
$27.50
$27.50
$27.50
$27.50
$27.50
$27.50

Repair Unit Price
$209.84
$214.11
$214.11
$261.93
$261.93
$261.93
$526.19
$546.18
$695.87

B: Please see attached list of devices. There may be a small number of additional devices to be tested at
the 16 Munson Road, Farmington location and at the Medical Arts & Research Building on the Main
Campus. These will be priced the same as similar devices on the list.
All other terms and conditions remain unchanged.
This Addendum must be Signed & Returned with your bid.
________________________________
Authorized Signature of Bidder

______________________________
Company Name
Approved ______________________________________
Jennifer K. Kelley
Purchasing Services Officer
(Original Signature on file in UCHC Purchasing Department)

Dated Issued: October 4, 2006

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

1
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7
8
9
10
11
12
13
14
15
16
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19
20
21
22
23
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25
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49
50
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58
59
60
61
62
63
64
65
66

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

C-SUB BASEMENT
C-SUB BASEMENT
C-SUB BASEMENT
L- PENTHOUSE
L- PENTHOUSE SEC.1
L- PENTHOUSE SEC. 1
C-PENTHOUSE SEC. 1
L- PENTHOUSE SEC. 1
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE SEC. 2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC. 2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC.2
L- PENTHOUSE SEC. 3
L- PENTHOUSE SEC. 2
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE SEC. 2
L- PENTHOUSE SEC. 3
H-PENTHOUSE
H-PENTHOUSE
H-PENTHOUSE
H-PENTHOUSE
H-PENTHOUSE
H-PENTHOUSE
L-7097A
H-M028
A-M048
A-M048
A-M048
A-M048
L-7031A
L-7031A
L- PENTHOUSE
L- PENTHOUSE SEC. 3
L- PENTHOUSE SEC. 3
L- PENTHOUSE
L- PENTHOUSE SEC. 2
H-PENTHOUSE
H-PENTHOUSE
H-SUB BASEMENT
C-SUBBASEMENT
C-SUBBASEMENT
C-PENTHOUSE
C-PENTHOUSE
C-PENTHOUSE
L-4088
L-4088
H- 7TH FLOOR
H - 6TH FLOOR
H - 5TH FLOOR
H - 4TH FLOOR
H - 3RD FLOOR
H - 2ND FLOOR
H - 1ST FLOOR
L-B003
B-3007
B-2010
B-4008
B-5006
L-B005

HOT WATER HEATER 1&2
HOT WATER HEATER 1&2 BYPASS
ORAL SUCTION UNIT
BEHIND BL - 23
COPMRESSOR
CHILLER
HWH
HWH BYPASS
TANK MAKE UP WATER ACROSS FROMSNET
FAST FILL TANK ACROSS FROM SNET
HWH #2
HWH # 2 BYPASS
HWH # 3
HWH # 3 BYPASS
CHILLER
WATER CHILLER 1 OF 2
BLAZER TOWER # 8
BLAZER TOWER # 7
BEHIND TANK 4 HWH
ACROSS FROM CLEAVER BROOKS ROOM
HWH # 4 BYPASS
HWH # 4
HW FEED TO CLEAVER BROOKS ROOM
NEXT TO BAC TOWERS
NEAR AIR STATION # 2
RIGHT OF EXH 63 NEXT TO EYEWASH
FRONT SIDE OF BL 47
BLOWER 70
NEXT TO BL 46
BL 48 HUMIDIFICATION

4-1599 List of Devices.xls

PERCHLORIC HOOD SCRUBBERS

R.O. SYSTEM
CLEAVER BROOKS ROOM MAKE UP WATER
HWH BYPASS
HWH
BL 42
COLUMN NEXT TO BL 57
COLUMN NEXT TO EXH 87
EXH 88
LAB AIR
LAB AIR
HOT WATER ABOVE HOOD
COLD WATER ABOVE HOOD
SOILED UTILITY ROOM
SOILED UTILITY ROOM
SOILED UTILITY ROOM
SOILED UTILITY ROOM
SOILED UTILITY ROOM
SOILED UTILITY ROOM
SOILED UTILITY ROOM

1 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

SERIAL
SIZE
#
(INCHES)

100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167

909
909 MIQT
909MIQT
909 QT
909 QT
909 QT
909
909
909 QT
909 MIQT
909
909
909
909
009 QT
009 QT
909 QT
909 QT
009 QT
009
909
909
909 QT
909
909
909
909
909
909
909
009
009
909
009
009
009
009
009
909
009
909
909
909
909
909
909
909
909
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

155780
330358
33226
466731
465690
465716
153340
331627
465698
332916
155053
331825
155052
327456
99197
99132
465700
460189
99146
99115
332239
154843
468136
465709
465682
466354
466304
465686
466355
465695
96589
86274
464571
86252
94715
99210
99167
95110
465683
99206
466364
337182
466295
330360
191952
465708
465691
466357
464572
86260
79046
78000
96604
99118
99209
99188
99136
96613
96618
96608
99155
96576
95116
105746
105736
94637

3.00
2.00
1.25
0.75
0.75
0.75
3.00
2.00
0.75
1.50
3.00
2.00
3.00
2.00
0.50
0.50
0.75
0.75
0.50
0.50
2.00
3.00
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.50
0.50
0.75
0.75
0.50
0.50
0.50
0.50
0.75
0.50
0.75
1.50
0.75
2.00
4.00
0.75
0.75
0.75
0.75
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER
BLDG/LOCATION

67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131

L-B002
L-5093
L-5093
L-5093
B-5008
B-6010
B-6007
B-1007
B-4009
L-5096
L-5096
B-4011
B-4006
B-3011
B-3008
B-3010
L-5081
L-5081
B-4010
L-2085A
L-2085
L-2085
L-2092
L-2092
L-2087
L-2092
L-2092
L-2087A
L-2087
L-2087
L-7007
L-7007
L-4091
L-4091
L-1091
L-4091
L-5074
L-5074
L-5074
L-3031A
L-5074
L-3031A
L-3051A
L-6087A
L-6087A
L-1031A
L-1031A
L-1031A
L-7031A
L-2031C
L-2031C
L-2031C
L-5021A
L-5021A
L-5021A
L-4018A
L-4018A
L-4018A
L-5079A
L-5079A
L-5079A
L-7097A
C-2104
B-3006
B-1011
L-2019A

4-1599 List of Devices.xls

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

DEVICE/LOCATION

BELOW CEILING HOOD WALL
HOT WATER - CENTER ISLAND
COLD WATER - CENTER ISLAND
COLD WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
HOT
COLD
COLD WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT IN CEILING ABOVE SMALL SINK
COLD IN CEILING ABOVE SMALL SINK
RIGHT SIDE WALL
COLD WATER RIGHT SIDE WALL
HOT WATER RIGHT SIDE WALL
ON WALL SMALL OFFICE
COLD WATER
HOT WATER
HOT WATER HOOD WALL
COLD WATER HOOD WALL
COLD WATER
HOT WATER POTABLE WALL
COLD WATER LEFT WALL
HOOD WALL (ALSO L-4097 SOUTH WALL)
LEFT WALL
COLD WATER (POTABLE WALL)
HOT WATER (POTABLE WALL)
GLASS WASHER
AUTOCLAVE
BOTTLE WASHER
AUTOCLAVE
BOTTLE WASHER
AUTOCLAVE
AUTOCLAVE
BOTTLE WASHER
ELECTRIC STEAM BOILER
AUTOCLAVE

DIRTY UTILITY RM NEXT TO C2096

2 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
231
232
233
234
235
236
237
239
238
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
009
909
009
909
009
009
909
009
909
909
009
009
909
009
009
909
009
009
909
909
009
009
009
009

SERIAL
SIZE
#
(INCHES)
105899
105729
105759
105775
105751
105910
105728
94608
95122
94606
99212
105752
105783
105797
105723
105750
105787
105773
105758
105918
105961
105799
466362
465715
105903
105794
105767
105931
105740
105780
105747
105754
105772
105698
105959
105928
105902
105913
105656
105777
105907
474389
105933
474391
105904
474388
105943
105932
474396
105939
465702
466741
105769
105779
466305
105781
105768
466344
105935
105946
466358
474413
106170
106172
105940
105595

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75
0.75
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75
0.50
0.75
0.50
0.75
0.50
0.50
0.75
0.50
0.75
0.75
0.50
0.50
0.75
0.50
0.50
0.75
0.50
0.50
0.75
0.75
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER
BLDG/LOCATION

132
133
134
135
136
137
138
139
140
141
142
143
144
144
145
145
146
146
146
147
147
148
149
149
150
150
151
151
152
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188

L-2019A
L-3082A
L-2019A
L-3082A
L-3082A
L-3082A
L-3082
B-1010
B-2007
A-M0274
A-M0274
A-M0274
D-1000
L-1079A
E-1000
L-1079A
A-SUB BASEMENT
C-AMTU
L-1079A
C-AMTU
C-2036
H-M049
L-4038
K-SUB BASEMENT
E-7053
L-4038
E-1009
L-4015
E-4053
L-4015
E-7009
E-2009
E-1030
E-6009
E-6053
E-6030
E-1038
E-HUM5 & K-SB
E-7038
E-PENTHOUSE
E-7023
E-PENTHOUSE
E-7009
E-7053
K-SUB BASEMENT
E-7014
E-PENTHOUSE
E-6014
E-3030
E-4014
K-SUB BASEMENT
E-6009
E-5038
E-4038
E-4030
E-3014
E-4009
E-5030
E-5009
E-3038
E-SECOND FLOOR
E-5009
E-3009
E-2009
E-2053
E-SECOND FLOOR

4-1599 List of Devices.xls

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

DEVICE/LOCATION

AUTOCLAVE

COLD WATER PROTECTS L-3081
HOT WATER PROTECTS L-3081

AUTOCLAVE
AUTOCLAVE
GLASS WASHER
BOILER ROOM
AUTOCLAVE
BOILER ROOM MAKE UP WATER BOILERS
AUTOCLAVE
DOMESTIC WATER BYPASS
SOILED LINEN RM IN CEILING
GLASS WASHER
FEEDS FISH TANK
BEHIND AUTOCLAVES
OVER SINK
COLD WATER
TAF SUBBASEMENT WATER TO LABS
HOT WATER TO 7053 & 7052 IN CEILING
HOT WATER
COLD WATER IN CEILING
HOT WATER
COLD WATER TO 4052 & 4053 IN CEILING
COLD WATER
COLD WATER IN CEILING
HOT WATER IN CEILING
COLD WATER TO 1029 & 1030 IN CEILING
HOT WATER IN CEILING
COLD WATER TO 6052 & 6053 IN CEILING
COLD WATER TO 6029 & 6030 IN CEILING
COLD WATER TO 1037 & 1038 IN CEILING
COLD WATER TO 7037 & 7038 IN CEILING
ALONGSIDE ELEVATORS
DOORWAY
OPPISITE ELEVATOR ON BACK SIDE
HOT WATER TO AUTOCLAVE, SINK ETC.
COLD WATER TO 7052 & 7053
FEEDS HUMIDIFIER SOUTH WALL
HOT WATER TO ROOMS 7013 & 7014
OPPISITE ELEVATOR IN CEILING
COLD WATER TO ROOMS 6013 & 6014
COLD WATER TO ROOMS 3029 & 3030
COLD WATER TO ROOMS 4013 & 4014
FEEDS HUMIDIFIER WEST END
COLD WATER
COLD WATER TO ROOMS 5037 & 5038
COLD WATER TO ROOMS 4037 & 4038
COLD WATER TO ROOMS 4029 & 4030
HALLWAY IN CEILING
HOT WATER TO ROOM 4009
COLD WATER TO ROOMS 5029 & 5030
COLD WATER TO ROOM 5009
COLD WATER TOROOMS 3037 & 3038
DARK ROOM IN CEILING
HOT WATER TO ROOM 5009
COLD WATER TO ROOM 3009
COLD WATER TO ROOM 2009
COLD WATER TO ROOMS 2052 & 2053
COLD WATER TO DARK ROOM
3 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

265
266
267
268
269
270
271
272
273
274
275
276
226
277

909
909
009
009
009
009
009
009
009
009
009
909
909
009
009
009
009
009
909
009
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

278
219
279
221
280
282
514
283
074
284
260
285
586
159
067
504
433
466

537
565
626
585
515
642
573
490
180
276
503
372
302
314
223
328
383
416
188
165
417
248
158
148
164

SERIAL
SIZE
#
(INCHES)
474416
474214
105936
106268
106175
105937
105952
105929
105753
106173
106264
474439
01572
106269
07951
106153
05129
105332
474222
106476
474011
110665
105927
112129
136368
105792
136369
105955
136371
99173
136372
136374
136376
136379
136382
136385
136388
136389
136390
136397
136400
136401
136409
136411
136413
136420
136421
136422
136423
136424
136426
136433
136619
136621
136622
136625
136626
136628
136630
136631
136632
136633
136634
136635
136637
136644

0.75
0.75
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75
1.25
0.50
3.00
0.50
3.00
0.50
0.75
0.50
0.75
0.50
0.50
2.00
0.75
0.50
0.75
0.50
0.75
0.50
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

E-5014
E-FOURTH FLOOR
E-FOURTH FLOOR
E-3053
E-3009
E-4009
E-7014
E-1009
E-1014
E-7030
E-2014
E-2038
E-1053
E-2030
E-6038
E-5053
E-1038
E-PENTHOUSE
C-BASEMENT
C-BASEMENT
E-SUB BASEMENT
K-SUB BASEMENT
L- PENTHOUSE
C-SUB BASEMENT
C-SUB BASEMENT
J-WAREHOUSE
7
3
4
D-1000
1
D-1000
A-BASEMENT
27
C-BASEMENT
C-BASEMENT
A-SUB BASEMENT
E-SUB BASEMENT
L- PENTHOUSE
A-BASEMENT
2
E-SUB BASEMENT
1
H-PENTHOUSE
C-SUB BASEMENT
H-M047
H-PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
E-5038
E-6045
E-1027
E-2014
E-3027
E-SIXTH FLOOR
E-5023
E-6027
E-5027
E-6027
E-4038
E-2022
E-6053
E-5053
E-3030
E-3027
E-2045

COLD WATER TO ROOMS 5013 & 5014
DARK ROOM HOT WATER IN CEILING
DARK ROOM COLD WATER IN CEILING
COLD WATER TO ROOMS 3052 & 3053
HOT WATER IN CEILING
COLD WATER IN CEILING
COLD WATER TO ROOMS 7013 & 7014
HOT WATER TO ROOM 1009
COLD WATER TO ROOMS 1013 & 1014
COLD WATER TO ROOMS 7029 & 7030
COLD WATER TO ROOMS 2013 & 2014
COLD WATER TO ROOMS 2037 & 2038
COLD WATER TO ROOMS 1052 & 1053
COLD WATER IN ROOMS 2029 & 2030
COLD WATER IN ROOMS 6037 & 6038
COLD WATER TO ROOMS 5052 & 5053
OUTSIDE ROOM IN HALLWAY
ALONGSIDE AHU-3
RMW ROOM
ROOM CB009 (CONTAINMENT)
MECHANICAL ROOM SOUTH WALL
MECHANICAL ROOM SOUTH WALL
BY CLEAVER BROOKS ROOM
ACROSS FROM BL# 51
COOLING FOR DENTAL COMPRESSOR
SUPPLY BUILDING EAST WALL
MACHINE ROOM
JANITOR CLOSET 1002A
JANITOR CLOSET
BOILER ROOM
WOMANS ROOM
BOILER ROOM FIRE SYSTEM
EAST END CHILLER ROOM
WHITE ROOM FIRST FLOOR
RMW ROOM C-B002
CB009 NEAR CCS SWITCH GEAR ROOM
WEST STAIRWELL
MECHANICAL ROOM SOUTH WALL
CLEAVER BROOKS ROOM WEST WALL
CHILLER ROOM SOUTHEAST CORNER
ROOM 21005A D.I. WATER ROOM
HOT WATER TO R.O. SYSTEM
BOILER ROOM NORTH WALL
CHILLED WATER MAKEUP AT PUMPS
ORAL SUCTION UNIT
WEST WALL
MAKEUP TO CHILLED WATER SYSTEM
EXHAUSTER # 54 & 56 WASH DOWN SYSTEM
EXHAUSTER # 54 & 56 WASH DOWN SYSTEM
HOT WATER TO ROOMS 5037 & 5038
HOT WATER TO ROOM 6048
HOT WATER TO ROOM 1025
HOT WATER TO ROOMS 2013 & 2014
HOT WATER TO ROOM 3025
DARK ROOM
ABOVE DOOR AT ENTRANCE
HALLWAY IN FRONT OF 6027 IN CEILING
HALLWAY IN FRONT OF 5027 IN CEILING
HALLWAY IN FRONT OF 6027 IN CEILING
HALLWAY IN FRONT OF 4038 IN CEILING
ABOVE DOOR AT ENTRANCE
HALLWAY IN FRONT OF 6053 IN CEILING
HALLWAY IN FRONT OF 5053 IN CEILING
HALLWAY IN FRONT OF 3030 IN CEILING
HALLWAY IN FRONT OF 3027 IN CEILING
ABOVE DOOR AT ENTRANCE

4-1599 List of Devices.xls

4 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

406
336
335
241
249
329
567
073
no tag
548
132
103
003
090
454
352

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
909
009
009
909
909
909
909
909
909
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

B-214

223
228
224

222

225

208

371
444
042
133
201
508
399
477
395
476
303
124
432
351
200
400

SERIAL
SIZE
#
(INCHES)
136648
136654
136663
136682
136684
136699
136747
136757
136767
136770
136776
136794
136802
136803
136806
136808
13688
13688
144216
144217
153549
153818
154843
155780
166618
174189
177537
182666
182673
221917
237442
242678
242811
247130
248299
248304
249638
251683
273887
284032
29714
30039
305152
306425
332267
350958
396872
460186
466367
82960
82969
82994
82998
83004
83005
83008
83009
83011
83014
83015
83020
83022
83023
883025
83026
83027

0.75
0.75
0.75
0.50
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
0.75
3.00
3.00
3.00
3.00
3.00
3.00
1.50
4.00
2.00
2.00
2.00
1.00
2.00
6.00
6.00
1.50
6.00
6.00
6.00
6.00
1.25
1.50
2.00
1.50
1.00
0.75
1.25
1.00
0.75
0.75
0.75
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

E-4053
E-2022
E-2045
E-2027
E-7027
E-5030
E-2038
E-7045
E-3053
E-7027
E-2027
E-1027
E-6038
E-4030
E-1038
E-1030
E-3038
E-6030
E-4027
E-6045
E-1053
E-2045
E-1045
E-3045
E-1045
E-7045
E-5045
E-7038
E-5045
E-4014
E-4045
E-6014
E-5027
E-SIXTH FLOOR
E-7030
E-2030
E-5014
E-4023
E-4027
E-4045
E-1014
E-3045
E-3014
E-2053
C-MAIN FLOOR
C-2036
L- PENTHOUSE
L-4015
L-4015
L-4090
L-4090
L-7004
L-7004
L-7004
L-7004
L-7007
L-7007
L-7012
L-7012
L-71012
L-7008
L-7008
L-7008
L-7008
L-7011
L-7011

HALLWAY IN FRONT OF 4053 IN CEILING
ABOVE DOOR AT ENTRANCE
HALLWAY IN FRONT OF 2045 IN CEILING
HALLWAY IN FRONT OF 2027 IN CEILING
HALLWAY IN FRONT OF 7027 IN CEILING
HALLWAY IN FRONT OF 5030 IN CEILING
HALLWAY IN FRONT OF 2038 IN CEILING
HALLWAY IN FRONT OF 7045 IN CEILING
HALLWAY IN FRONT OF 3053 IN CEILING
HALLWAY IN FRONT OF 7027 IN CEILING
HALLWAY IN FRONT OF 2027 IN CEILING
HALLWAY IN FRONT OF 1027 IN CEILING
HALLWAY IN FRONT OF 6038 IN CEILING
HALLWAY IN FRONT OF 4030 IN CEILING
HALLWAY IN FRONT OF 1038 IN CEILING
HALLWAY IN FRONT OF 1030 IN CEILING
HALLWAY IN FRONT OF 3038 IN CEILING
HALLWAY IN FRONT OF 6030 IN CEILING
HALLWAY IN FRONT OF 4027 IN CEILING
HALLWAY IN FRONT OF 6045 IN CEILING
HALLWAY IN FRONT OF 1053 IN CEILING
ABOVE DOOR AT ENTRANCE
HALLWAY IN FRONT OF 1045 IN CEILING
HALLWAY IN FRONT OF 3045 IN CEILING
HALLWAY IN FRONT OF 1045 IN CEILING
HALLWAY IN FRONT OF 7045 IN CEILING
HALLWAY IN FRONT OF 5045 IN CEILING
HALLWAY IN FRONT OF 7038 IN CEILING
HALLWAY IN FRONT OF 5045 IN CEILING
HALLWAY IN FRONT OF 4014 IN CEILING
HALLWAY IN FRONT OF 4045 IN CEILING
HALLWAY IN FRONT OF 6014 IN CEILING
HALLWAY IN FRONT OF 5027 IN CEILING
DARKROOM IN CEILING
HALLWAY IN FRONT OF 7030 IN CEILING
HALLWAY IN FRONT OF 2030 INCEILING
HALLWAY IN FRONT OF 5014 IN CEILING
ABOVE DOOR AT ENTRANCE
HALLWAY IN FRONT OF 4027 IN CEILING
HALLWAY IN FRONT OF 4045 IN CEILING
HALLWAY IN FRONT OF 1014 IN CEILING
HALLWAY IN FRONT OF 3045 IN CEILING
HALLWAY IN FRONT OF 3014 IN CEILING
HALLWAY IN FRONT OF 2053 IN CEILING
AMTU SOILED LINEN ROOM SLOP SINK
AUTOCLAVE
ACROSS FROM CLEAVER BROOKS ROOM
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER

4-1599 List of Devices.xls

HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
5 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

261
123
113
116
559
384
104
525
240
560
115
043
453
313
050
066
189
465
298
445
002
114
037
208
036
526
362
536
361
277
296
489
393
507
547
091
407
287
299
295
014
207
222
149
218
281

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

286
287
288
289
290
291
292
293
297
298
299
300
301
302
303
304
305
306
307

SERIAL
SIZE
#
(INCHES)
83028
83030
83032
83033
83034
83036
83037
83039
83040
83041
83042
83043
83044
83045
83048
83049
83050
83051
83052
83053
83055
83057
83058
83059
83060
83061
83062
83063
83064
83065
83066
83067
83068
83070
83071
83073
83074
83076
83077
83078
83079
83080
83081
83082
85885
97705
95115
106179
106176
105949
105770
105942
106178
106174
106185
105744
105762
106183
106169
105023
99145
105941
106177
105024
106182
106267

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
1.00
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
346
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-7011
L-7013
L-7013
L-7019
L-7019
L-7019
L-7021
L-7021
L-7020
L-7031
L-7031
L-5078
L-5078
L-5086
H-PENTHOUSE
C-BASEMENT
C-BASEMENT
H-PENTHOUSE
H-PENTHOUSE
H-PENTHOUSE
I-DOWLING SOUTH
5
I-DOWLING SOUTH
4
A-SUB BASEMENT
A-SUB BASEMENT
L-SUB BASEMENT 003
I-DOWLING SOUTH
20
G-DOWLING NORTH
G-DOWLING NORTH
I-DOWLING SOUTH
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
L- PENTHOUSE
E-3030
E-4023
E-7023
E-6023
E-6023
A-SUB BASEMENT
E-BASEMENT
E-PENTHOUSE
E-1023
E-1023
L-7003
L-7003
L-7003
L-7041
L-7041
L-7044
L-7044
L-7044
L-7045
L-7045
L-7045
L-7052
L-7052
L-7051
L-7051
L-7051
L-7051

HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
ABOVE SURGAL VACUUM PUMPS
HEAT EXCHANGER
HEAT EXCHANGER
HOT WATER HEATERS
HOS HOT WATER HEATER
NEAR LOW PRESSURE STEAM GENERATOR
MACHINE ROOM
BEHIND AUTOCLAVE
MACHINE ROOM ABOVE WATER HEATER
MACHINE ROOM
FIRE PUMP
CHILLER ROOM FIRE PUMP
FIRE LINE
LOWER SHOP OFFICE
G023 FIRE SYSTEM
G1E1 MACHINE ROOM FIRE LINE
C1E1 MACHINE ROOM FIRE LINE
MECH ROOM FOR COOLING TOWER
NEAR FLASH TANK FOR CLEAVER BROOKS
HEAT EXCHANGER DHW SECT 3
SECT 2 BEHIND RO WATER SYSTEM
SECT 2 HEAT EXCHANGER
SECT 2 HEAT EXCHANGER - HOT WATER HTR
SECT 1 FULTON BOILER
SECT 1 ABOVE HOT WATER HEATER
ABOVE DOOR AT ENTRANCE
ABOVE DOOR AT ENTRANCE
ABOVE DOOR AT ENTRANCE
ABOVE DOOR AT ENTRANCE
ABOVE DOOR AT ENTRANCE
CHILLER ROOM NEXT TO CAGE
HALLWAY 20' FROM ELEV ON RIGHT
ALONG SIDE AHU-3
OUTSIDE ROOM IN HALLWAY
OUTSIDE ROOM IN HALLWAY
COLD WATER CUP SINK
HOT WATER
COLD WATER

4-1599 List of Devices.xls

COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
6 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

308
309
310
311
312
313
314
315
316
317
318
319
320
321
B-211
B-216
B-215
B-210
B-209
6
228

009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
909
909
909
909
009
009
975XL
009
009
909
909
909
909
825
009
909
009
825Y
909
909
909
909
909
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

229

FEBCO

229
206-B
B-207
B-204
B-203
B-202
201-B
B-200
181
286
566
483
482
621
627
030
031
296
295
294
322
323
324
325
326
329
330
331
332
333
334
335
336
337

SERIAL
SIZE
#
(INCHES)
105789
105774
106171
105690
105930
106265
105917
105796
106166
105938
105925
105950
105916
105923
166606
166625
166609
166608
166613
01293
25702
24178
23335
45730
622566
242979
242886
248037
4780
14595
249303
25111
AH1389
166610
166621
179291
179286
284602
166612
83025
83000
83072
83075
83002
60053
83029
136399
83046
83038
106168
106167
105922
105945
105953
105657
105944
105947
94680
105915
105911
105908
105951
105795
105948
105680
105255

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
1.50
1.50
1.50
1.50
1.50
1.25
0.75
0.50
0.75
1.25
8.00
6.00
6.00
6.00
6.00
3.00
6.00
0.75
1.25
1.50
1.50
2.00
2.00
1.00
1.50
0.50
0.50
0.50
0.50
0.50
1.00
0.50
0.75
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-7016
L-7016
L-7059
L-7059
L-7059
L-7058
L-7058
L-7039
L-7039
L-7074
L-7074
L-7074
L-7078
L-7078
L-7078
L-7078
L-7082
L-7082
L-7082
L-7029
L-7029
L-7060
L-7060
L-7087
L-7087
L-7087
L-7087A
L-7087A
L-7099
L-7099
L-7090
L-7090
L-7090
L-7091
L-6056
L-6056
L-6056
C-2056
L-7035
L-7035
L-7089
L-7089
L-7089
L-7089
L-6010
L-6010
L-6010
L-6010
L-7098
L-7098
L-7098
L-7102
L-7102
L-7102
L-7107
L-7107
L-7107
L-7121
L-7121
L-6004
L-6004
L-6004
L-6012
L-6012
L-6012
L-6011

COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
FOR SINK IN RADIATION ROOM
FOR SINK IN RADIATION ROOM
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
PROTECTS DARKROOM MIXING VALVE
PROTECTS DARKROOM MIXING VALVE

4-1599 List of Devices.xls

COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER (HOOD)
COLD WATER
HOT WATER
COLD WATER ( LASER COOLING)
COLD WATER
7 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

338
339
340
341
342
343
344
346
347
348
349
350
351
352
353
354
355
356
357
327
328
358
359
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
009

SERIAL
SIZE
#
(INCHES)
99114
99123
105765
105771
105904
105957
99170
99153
99158
105960
105912
105905
105906
105791
105924
105901
105739
105782
94609
105675
105934
105909
96571
105920
105748
105778
105742
105749
105669
105741
105760
99139
105725
99179
94619
99156
99184
105788
105766
99131
99180
105735
96559
99147
105757
105784
99130
96617
99143
96570
88466
99177
99157
96596
96607
105919
99164
96541
95103
105745
105743
96609
99150
99127
471043
99198

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT

BLDG/LOCATION

DEVICE/LOCATION

L-6011
F-B021
F-B021
L-4037
L-4037
L-4037
L-4039
L-4039
L-4039
L-6014
L-6014
L-4056
L-4056
L-4056
L-2004
L-2004
L-2004
L-5086
L-5086
L-5088
L-5088
L-7058
L-2002
L-2002
L-2002
L-6014
L-6014
D BLDG. OUTSIDE
L-2004A
L-6002
L-6002
L-7043
L-7043
L-7043
L-7043
L-7042
L-7042
L-6037
L-6037
L-6037
L-6016
L-6016
L-2004
L-2004
L-6035
L-6035
L-7034
L-7034
L-7027
L-7018
L-7018
L-6020
L-6020
L-3052
L-3052
L-3052
L-3015
L-3015
L-3015
L-3015
L-3015
L-7012
L-7012
L-6019
L-6019
L-6019

HOT WATER
COLD WATER FOR F-B020
FEED FOR F-B020
COLD WATER
HOT WATER
COLD WATER

4-1599 List of Devices.xls

NEW
DATE
TESTED

COLD WATER
HOTWATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
WINDOW WALL CUP SINK
COLD WATER
HOT WATER

COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
SEASONAL BY CHILLER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
X-OMAT
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER

HOT WATER
COLD WATER
COLD WATER
HOT WATER

8 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
345
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
468
469
470

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
99168
99121
105898
99187
99199
99140
105764
105790
99196
105800
105727
105734
105763
105755
99122
99189
99190
105921
105798
105926
99154
105785
99126
105761
105737
99172
94625
332265
99135
99208
99125
105954
99138
99143
99192
105756
99152
99124
99525
80581
99165
95125
99149
99203
99119
99186
79687
105900
99169
99185
95101
96586
105863
99207
99183
95105
99128
96575
99193
99213
99181
99141
99175
105869
99163
105975

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
1.25
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT

BLDG/LOCATION

DEVICE/LOCATION

L-6046
L-6046
L-6032
L-6032
L-7049
L-7049
L-6032
L-6032
B-7005
B-7005
L-6073
L-6073
L-6032
L-4040
L-4040
L-6063
L-6063
L-6076
L-6076
L-6076
L-6031
L-6031
L-6047
L-6047
L-6047
L-6078
L-6078
L-6078
L-6120
L-6120
L-6106
L-6106
L-6106
L-6103
L-6103
L-6099
L-6099
L-6099
L-6093
L-6093
L-6083
L-6083
L-6083
L-6083
L-6052
L-6052
L-6088
L-6088
L-6087
L-6087
L-6087
L-6055
L-6055
L-6055
L-4052
L-4052
L-4052
L-4056
L-6096
L-6096
L-6096
L-5002
L-5002
L-5004
L-5004
L-5011

COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER north sink
HOT WATER north sink

4-1599 List of Devices.xls

NEW
DATE
TESTED

COLD WATER
HOT WATER
COLD WATER south sink and hood
HOT WATER south sink
HOT WATER
COLD WATER
COLD BOX - COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER dark room
HOT WATER dark room
COLD WATER
HOT WATER
CUP SINK
COLD WATER
HOT WATER
COLD CUP SINK
COLD WATER
HOT WATER
CUP SINK
COLD WATER
HOT WATER
LAB HOOD 4056 & CUP SINK 4052
COLD WATER
HOT WATER
CUP SINK
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER ALSO DOES L-5006
9 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

471
472
466
467
473
474
475
476
477
478
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
578
579
580
581
582

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
99178
99211
105897
105893
105733
94639
106099
99117
99160
105252
106184
106263
106271
99182
99116
105014
106262
106270
106164
106152
99120
99205
106180
106156
106151
106157
106161
106048
106010
106027
106049
106034
106162
106045
106050
106159
106043
106165
106047
106160
106052
106046
106154
106053
106036
106041
106007
106026
106039
105964
106030
106158
106150
106163
106028
106040
106035
106031
106033
106018
106004
105859
106054
105886
105865
105864

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-5011
L-5012
L-5012
L-5012
L-5011
L-5011
L-5018
L-5018
L-5018
L-5018
L-5015
L-5015
L-5038
L-5038
L-5053
L-5053
L-5053
L-5052
L-5052
L-5051
L-5051
L-5051
L-5050
L-5050
L-5050
L-5054
L-5054
L-5054
L-5054
L-5043
L-5043
L-5047
L-5047
L-5047
L-5044
L-5044
L-5040
L-5040
L-5040
L-5049
L-5049
L-5049
L-5049
L-5034
L-5034
L-5020
L-5020
L-5019
L-5019
L-5019
L-5019
L-5019
L-5007
L-5007
L-5085
L-5085
L-5085
L-5083
L-5083
L-5079
L-5079
L-5041
L-4000
L-4000
L-4000
L-4000

HOT WATER ALSO DOES L-5006
HOOD WALL
HOT WATER CENTER ISLAND
COLD WATER CENTER ISLAND
HOT WATER CENTER ISLAND
COLD WATER CENTER ISLAND
COLD WATER
HOT WATER
COLD WATER CENTER WALL
HOT WATER CENTER WALL
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
CUP SINK
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
HOT WATER AND CUP SINK
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER AND CUP SINK
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOOD WALL
COLD WATER
HOT WATER
COLD WATER
HOT WATER

4-1599 List of Devices.xls

COLD WATER
HOT WATER

10 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

583
584
585
586
587
588
589
590
591
592
594
595
596
597
598
599
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
648
649
650
652

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
105892
105896
105726
106300
106303
105731
105641
106305
105836
105851
105615
105730
105847
105852
106057
106056
105840
105878
106065
105832
105833
105011
105866
105849
105025
106062
105839
105875
106086
105801
105835
106084
105810
105834
105802
105873
105805
105844
105857
105803
105850
105804
106075
105855
105843
105877
105870
105882
105874
105867
106085
105853
105841
106181
106082
106293
106308
106291
106266
106306
106292
106074
106287
105655
106307
106304

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
704
705
706
707
708
709
710
711
712
712
713
713
714
714
715
715
716

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-4097
L-4097
L-4097
L-4097
H-SB02
L-5056
L-5056
L-5057
L-5057
L-5072
L-5072
L-4063
L-4063
L-4060
L-4060
L-4046
L-4046
L-4046
L-4050
L-4050
L-4045
L-4045
B-6004
B-6004
L-3013
L-3013
L-3013
L-3013
L-3010
L-3010
L-3014
L-3014
L-6073
C-G054
L-6074
L-6074
L-4018
L-4018
L-5006
L-5006
L-4020
L-4020
L-4019
L-4061
L-4061
L-4061
L-5005
L-5005
L-4016
L-5005
L-4016
L-4012
L-4012
L-4012
L-4012
L-4009
L-4009
L-5021
L-4009
L-5021
L-4009
L-1062
F-M012
L-1062
L-4006
L-1062

COLD WATER
HOT WATER
COLD WATER
HOT WATER
ABOVE BLOWER # 42
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATE ALSO L-5076 CUP SINK
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATE DARK ROOM
HOT WATER DARK ROOM

4-1599 List of Devices.xls

COLD WATER
HOT WATER
HOT WATER ALSO L-4049
COLD WATER ALSO L-4049
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
MIXING VALVE
COLD WATER COLD BOX
HOT WATER COLD BOX

COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER

COLD WATER
HOT WATER
COLD WATER
HOTWATER
HOT WATER
COLD WATER
CUP SINK
HOOD
COLD WATER CENTER ISLAND
HOT WATER CENTER ISLAND

HOT WATER
BEHIND ENTRANCE ON LEFT
COLD WATER
COLD WATER

11 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

653
654
655
656
657
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
479
516
532
533
534
535
536
537
538
539
540
541
542
543
544
545
547
546
548
549
550
551
552
553
554
563
555
564
556
565
557
566
558
567

009
009
009
009
909
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
106285
106282
106286
106274
332264
106290
106298
105808
105806
106296
106301
105974
105988
105724
106297
106288
106299
106281
106277
106279
106284
106114
106272
106261
105998
106077
105984
106067
106110
105982
105980
106103
106155
105969
106029
106013
106042
106002
105966
106024
106017
105968
106037
105972
105971
106008
106011
106012
106032
106003
106015
106005
105963
106022
106021
106044
106025
106014
106016
106019
106051
105884
105887
106059
105965
105889

0.50
0.50
0.50
0.50
1.25
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

716
717
717
718
718
719
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT

BLDG/LOCATION

DEVICE/LOCATION

L-4006
L-1062
L-4006
L-4021
L-4006
L-4021
L-4006
L-4076
L-4076
L-4076
L-6039
L-6039
L-6038
L-6038
L-3009
L-3009
L-3009
L-1091
L-1091
L-1091
L-1075
L-1075
A-M028
A-M028
A-M032
A-M032
A-M032
L-1081
L-1081
L-1081
L-2008
L-2008
L-2008
L-2083
L-2083
L-3057
L-3057
L-3057
L-3057
L-3054
L-3054
L-3002
L-3002
L-3002
L-3002
L-3008
L-3008
L-3009
L-3009
L-3010
L-3010
L-3010
L-3031
L-3031
L-3031
L-3031
L-5056
L-3004
L-3004
L-3004
L-3004
L-3011
L-3011
L-3032
L-3032
L-3032

HOT WATER

4-1599 List of Devices.xls

NEW
DATE
TESTED

COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER CENTER ISLAND
COLD WATER CENTER ISLAND
COLD WATER COLD BOX
HOT WATER COLD BOX
HOT WATER
COLD WATER
COLD WATER
HOT WATER
CUP SINK
COLD WATER
HOT WATER
CUP SINK
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
CUP SINK
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER

HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER (COLD BOX)
HOT WATER (COLD BOX)
HOT WATER
COLD WATER
COLD WATER
12 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

559
568
560
569
561
570
562
571
572
573
574
575
576
577
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909

SERIAL
SIZE
#
(INCHES)
106020
105858
106009
105970
105967
106023
106006
105838
105879
106073
99202
99144
96610
99134
106259
106250
99200
99161
99171
99151
106258
106255
105842
105846
105861
105860
105876
99174
106243
106283
106249
106234
106232
106273
106276
106253
105809
105807
106275
105837
105831
106280
106257
106251
106256
105848
99162
95127
99148
105981
105894
106058
105845
105830
106289
106278
106197
106205
106258
106212
106226
99176
99191
105265
105290
474441

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-3049
L-3049
L-3049
L-3049
L-3049
L-3053
L-3053
L-3053
L-3056
L-3056
L-3056
L-3059
L-3059
L-3060
L-3060
L-3062
L-3062
L-3062
L-3062
L-3075
L-3075
L-3080
L-3080
L-3085
L-3085
L-3089
L-3089
L-3091
L-3091
L-3091
L-3091
L-3091
L-3087
L-3087
L-3086
L-3086
L-2053
L-2053
L-1005
L-1005
L-1009
L-1009
L-3007
L-3007
L-3018
L-3018
L-3018
L-3018
L-3038
L-3038
L-3041
L-3041
L-3042
L-3042
L-3042
L-3042
L-3048
L-3048
L-3040
L-3040
L-3040
L-3040
L-3040
L-3084
L-3084
L-3078

COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER COLD BOX
HOT WATER COLD BOX
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER COLD BOX
HOT WATER COLD BOX
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER COLD BOX
HOT WATER COLD BOX
COLD WATER COLD BOX

4-1599 List of Devices.xls

13 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
804
805
806

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
99159
99137
99133
99129
106218
106247
106144
106148
95107
94611
99201
106216
106717
106240
106228
106199
106202
106215
106223
106227
106214
106192
106195
106230
106117
106191
106198
105263
105253
106210
99166
99194
106145
106138
99204
99195
106142
106141
106206
106203
106211
106189
106222
106207
106220
106229
106221
106225
106236
106224
106246
106252
106241
106245
106219
106237
106231
106213
106108
106204
106209
106208
106235
106066
106089
106090

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT
NEW
DATE
TESTED

BLDG/LOCATION

DEVICE/LOCATION

L-3078
L-3074
L-3074
L-3074
L-3034
L-3034
L-3072
L-3072
L-3072
L-2096
L-2096
L-2096
L-3043
L-3043
C-1147A
C-1147A
L-2088
L-2088
L-2086
L-2086
L-2040
L-2040
L-2052
L-2052
L-2052
L-2075
L-2075
L-2073
L-2073
L-2076
L-2076
L-2076
L-2076
L-2077
L-2077
L-2078
L-2078
L-2013
L-2013
L-2062
L-2062
L-2062
L-2062
L-3027
L-2038
L-2038
L-2038
L-2042
L-2042
L-2044
L-2044
L-2043
L-2043
L-2044
L-2044
L-2036
L-2036
L-2035
L-2019
L-2019
L-1072
L-1072
L-1072
L-2012
L-2012
L-2012

HOT WATER COLD BOX
COLD WATER
HOT WATER
COLD WATER
COLD WATER COLD BOX
HOT WATER COLD BOX
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER

4-1599 List of Devices.xls

14 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

807
808
809
810
811
812
813
814
815
818
819
820
802
803
816
817
821
822
823
824
827
828
829
830
831
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009

SERIAL
SIZE
#
(INCHES)
105872
105880
106109
105989
106115
106096
106076
106113
106097
106080
106106
106088
106140
106147
105986
105995
105993
105997
106068
106064
105996
106055
106071
105978
105958
106101
106104
105890
105979
106070
105985
106079
105885
106083
105994
106112
106001
105871
106060
105987
105976
106093
106072
106098
105862
106092
105722
105992
105991
106111
106105
106078
106095
105977
105983
106128
106124
105881
106130
106132
106260
106254
106233
106100
102484
106094

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

10/4/2006 D.SCRANTON

UNIVERSITY OF CONNECTICUT
HEALTH CENTER

911
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959

BACKFLOW PREVENTION DEVICE
INSPECTION AND MAINTENANCE REPORT

BLDG/LOCATION

DEVICE/LOCATION

L-2021
L-2021
L-2018
L-2018
L-2014
L-2010
L-2010
L-2014
L-2010
L-2010
L-2010
L-1003
L-1003
L-1041
L-1041
L-1057
L-1057
L-1100
L-1100
L-1100
L-1079
L-1079
L-2014
L-2014
L-2030
L-2030
L-2045
L-2045
L-2049
L-2049
L-2049
L-2056
L-2056
L-2056
L-2059
L-2060
L-2060
L-2060
L-1098
L-1098
L-1082
L-1090
L-1090
L-1089
L-1089
A-B008A
EG047
EG047
L5018

COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER
HOT WATER
COLD WATER

4-1599 List of Devices.xls

NEW
DATE
TESTED

COLDBOX
COLD WATER
HOT WATER
COLD WATER
HOT WATER
HOT WATER
COLD WATER
COLD WATER

15 of 15

FARMINGTON CONNECTICUT

TAG
#

WATTS
MODEL

SERIAL
SIZE
#
(INCHES)

876
877
878
879
880
882
883
884
885
886
887
888
889
890
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910
911
912
913
914
915
918
919
920
921
922
923
924

009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
009
909 QT
909 QT
009

106087
105891
106069
105895
106137
106118
106116
106091
106120
106133
106122
106128
106146
106136
106149
106194
105264
105010
105281
105013
106242
106244
106155
106127
106193
106131
106188
106125
105251
105256
105284
106000
106186
106134
105776
106143
106201
106200
105856
105257
106196
105285
105276
105026
105288
188171
474399
474494
106063

0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.75
0.75
0.50

10/4/2006 D.SCRANTON

INVITATION TO BID
UCHC-11 Rev. 12/04

Jennifer K. Kelley
Purchasing Services Officer

jkk1011@adp.uchc.edu
Email address

STATE OF CONNECTICUT
UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Munson Road Offices
263 Farmington Avenue
Farmington CT 06032
860-679-2408

Invitation to Bid
Specifications & Bid Documents Attached
Bid Number

Issue Date

4-1599

September 28, 2006

Bid Title:

Due Date & Time

October 13, 2006 at 3:30 PM

Backflow Device Testing & Repair

Acknowledgment: Receipt of Bid Documents
FAX to 860-679-2508
Please take a moment to acknowledge receipt of the attached bid documents. Your compliance with this request will help
us to maintain proper follow-up procedures while insuring that all vendors have the opportunity to submit a proposal.
Print or type the following information:
Company name:
Address:
City or Town:
Phone:
Fax:
Received by:
email:

NOTE: Use the label below when submitting sealed bids. Bids may be hand-delivered. Late bids will not be
accepted under any circumstances.
SEALED BID NO:
NOT TO BE OPENED UNTIL:

4-1599
October 13, 2006 at 3:30 PM

RETURN BID TO:
University of Connecticut Health Center
Purchasing Department, Munson Road Offices, MC4036
263 Farmington Avenue
Farmington, CT 06032

BIDDER’S CHECKLIST
UCHC-20 REV. 05/06

State of Connecticut
University of Connecticut Health Center
BIDDER’S CHECKLIST – READ CAREFULLY

BID NUMBER:

4-1599

IT IS SUGGESTED THAT YOU REVIEW AND CHECK OFF EACH ACTION AS YOU COMPLETE IT.
1. The Bid Proposal (UCHC-26) must be signed by a duly authorized representative of the
company. Unsigned bids automatically rejected.
2. The Proposal Schedule (UCHC-16) must be included with your bid and contain the following:
a. VENDORS NAME MUST BE IN THE UPPER RIGHT CORNER OF ALL PROPOSAL SCHEDULE
PAGES.
b. The bid prices you have offered have been reviewed and verified.
c. The price extensions and totals have been checked. (In case of discrepancy between unit prices and total
prices, the unit price will govern the bid evaluation).
d. Any errors, alterations, corrections or erasures to unit prices, total prices, etc. must be initialed by the
person who signs the proposal or his designee. Such changes made and not initialed mean automatic
rejection of proposal.
e. The payment terms are Net 30 Days (You may offer cash discounts for prompt payment). Cash
Discounts for Net Terms less than 30 days may be considered when evaluating bid pricing. Exception:
State of CT Small Business Set-Aside bids payment terms shall be in accordance with CGS 4a-60j.
f. The delivery information block has been completed. Be specific: In most cases, “as ordered” or “as
required” is not complete information.
3.
AFFIDAVITS: The following must be signed, notarized, and returned with bid. Failure to do so may result in
bid rejection. (If submitting electronically, rub or trace the Notary Seal with a soft pencil so it will show in the
scan.)
a.
“Form 1 Gift Certification”
b.
“Form 2 Campaign Contribution Certification”
c.
“Form 5 Consulting Agreement Affidavit”
d.
“Form 6A Affirmation of Receipt of Summary Of State Ethics Laws (Bid or Proposal)” must be signed
and returned with bid for bids over $500,000.00. Failure to do so may result in bid rejection
4.
Any technical or descriptive literature, drawing or bid samples that are required have been included with the bid.
5.
If required the amount of bid surety has been checked and the surety has been included.
6.
Form UCHC-45 (as applicable) must be completed entirely regardless of the number of employees, even if the
company is family owned and/or operated and must be submitted with each bid or bid may be rejected.
7.
Any addenda (UCHC-18) to the bid have been signed and included.
8.
MAKE SURE TO INCLUDE THE ORIGINAL PROPOSAL SCHEDULE PAGES (UCHC-16) ALONG WITH
ONE COPY (unless more copies are requested within the bid specifications).
9.
The bid number on the pre-addressed mailing label or on your hand marked return envelope exactly matches the bid
number inside the envelope.
10 . The pre-addressed mailing label has been used on your bid envelope or the bid envelope has been addressed as
follows:

SEALED BID NO:
NOT TO BE OPENED UNTIL:

11 .

4-1599
October 13, 2006 at 3:30 PM

RETURN BID TO:
University of Connecticut Health Center
Purchasing Department, Munson Road Offices, MC4036
263 Farmington Avenue
Farmington, CT 06032
The bid is mailed or hand-delivered in-time to be received no later than the designated opening date and time.
Late bids are not accepted under any circumstances. Please allow enough time if mailing in your bid. Handdelivered bids must be delivered to 16 Munson Road, Farmington, CT 06032.

THIS FORM NEED NOT BE RETURNED WITH YOUR BID.

BID PROPOSAL

THIS FORM AND

STATE OF
CONNECTICUT

UCHC 26 REV 12/04

REQUIRED PROPOSAL
SCHEDULE FORMS
MUST BE RETURNED

UNIVERSITY OF CONNECTICUT HEALTH
CENTER

Jennifer K Kelley

PURCHASING DEPARTMENT MC4036

Purchasing Services Officer

MUNSON ROAD OFFICES
263 Farmington Avenue

Read & Complete
Carefully

Farmington, CT 06032

860-679-2408
Telephone Number

Page 1 of 5

BID NO:

BID DUE DATE:

BID DUE TIME:

BID SURETY:

DATE ISSUED:

4-1599

October 13, 2006

3:30 PM

See proposal schedule

September 28, 2006

DESCRIPTION:

Backflow Device Testing & Repair

TERM OF CONTRACT:

Date of Award through June 30, 2007, with option to renew for two
additional 1-year periods

Invitation to Bid: Pursuant to the provisions of Section 10a-151b of the General Statutes of Connecticut as amended, sealed
proposals will be received by the Purchasing Department of the University of Connecticut Health Center, at the address above for
furnishing the commodities and/or services.
IMPORTANT: ALL pages of this form, Sections 1 through 4 must be completed, signed and returned by the bidder as
part of the bid package. Failure to submit all pages of this form constitutes grounds for rejection of your bid.
SECTION 1 of 5: BIDDER INFORMATION
Complete Bidder Legal Business Name:
Taxpayer ID # (TIN):

SSN

FEIN

Write/Type SSN/FEIN Number Above

Business Name, Trade Name, Doing Business as (If different from above):
Business Entity:

Corporation
LLC Corporation
LLC Partnership
LLC Single Member
Non-Profit
Partnership
Individual/Sole Proprietorship
Note: If Individual/Sole Proprietor, Individual’s Name (As Owner) Must Appear in the Legal Business Name Block above.
Business
A. Sale Commodities
B. Medical Services
C. Attorneys Fees
D. Rental of Property
Type:
(REAL ESTATE &EQUIPMENT)

E. Other (Describe in detail)
Under this TIN, what is the primary type of business you provide to the State? Enter Letter from above:
Under this TIN, what other types of business might you provide to the State? Enter Letter from above:
Note: If your business is a Partnership, you must attach the names and titles of all Partners to your Bid submission.
Note: If your business is a Corporation, in which state are you incorporated?
Written signature of Person Authorized to sign Bids on behalf of the above named Bidder:
Date Executed

SIGN HERE
Type or Print Name of Authorized Person

Title of Authorized Person

Is your business currently a DAS Certified Small Business
Enterprise?

Yes (Attach a copy of Certificate)

If you are a State Employee, indicate your position, agency, and agency address:

No

BID PROPOSAL
UCHC 26 REV 12/04

STATE OF CONNECTICUT
UNIVERSITY OF CONNECTICUT HEALTH CENTER

THIS FORM AND
REQUIRED
PROPOSAL
SCHEDULE FORMS

Jennifer K Kelley

MUST BE RETURNED

PURCHASING DEPARTMENT MC4036

Purchasing Services Officer

MUNSON ROAD OFFICES
263 Farmington Avenue

Read & Complete
Carefully

Farmington, CT 06032

860-679-2408
Telephone Number

Page 2 of 5

Bidder Address

Remittance Address
(Same as Bidder Address

YES)

No. & Street:
City:
State:
Zip Code:
Email Address:
Web Address:
Contact Name:
Phone:
Cell Phone:
Fax:

SECTION 2 of 5: AFFIRMATION OF BIDDER
The above signed bidder affirms and declares:
1.

That this proposal is executed and signed by said bidder with full knowledge and acceptance of the provisions of Form UCHC-19
of current issue and in effect on the date of bid issue. Form UCHC-19, entitled Standard Bid and Contract Terms and Conditions
are made a part of the contract.

2.

That this proposal is executed and signed by said bidder with full knowledge and acceptance of the provisions of all Special Bid
Terms and Conditions attached hereto.

3.

That should any part of this proposal be accepted in writing by Director of Purchasing within ninety (90) calendar days from the
date of bid opening unless an earlier date for acceptance is specified by bidder in proposal schedule, said bidder will furnish and
deliver the commodities and/or services for which this proposal is made, in the quantities and at the prices bid, and in compliance
with the provisions of the STANDARD BID AND CONTRACT TERMS AND CONDITIONS, COMMODITY
SPECIFICATION, PROPOSAL SCHEDULE AND SPECIAL BID AND CONTRACT TERMS AND CONDITIONS. Should
award of any part of this proposal be delayed beyond the period of ninety (90) days or an earlier date specified by bidder in
proposal schedule, such award shall be conditioned upon bidder’s acceptance.

4.

Acceptance of the conditions set forth herein, agreement in strict accordance therewith, and will furnish and deliver the
commodities and/or services to the state agency or agencies named in the PROPOSAL SCHEDULE at the prices bid therein.

BID PROPOSAL

STATE OF CONNECTICUT

UCHC 26 REV 12/04

Jennifer K Kelley
Purchasing Services Officer

REQUIRED PROPOSAL

UNIVERSITY OF CONNECTICUT HEALTH CENTER

SCHEDULE FORMS

PURCHASING DEPARTMENT MC4036

MUST BE RETURNED

MUNSON ROAD OFFICES
263 Farmington Avenue

860-679-2408

THIS FORM AND

Farmington, CT 06032

Read & Complete
Carefully

Telephone Number

Page 3 of 5
SECTION 3 of 5: BIDDER DEBARMENT AND/OR SUSPENSION
The above signed bidder further affirms and declares that neither the bidder and/or any company official nor any subcontractor to the bidder and/or
any company official has received any notices of debarment and/or suspension from contracting with the State of Connecticut. Should Purchasing
Department determine that bidder has not completed Section 2 - Bidder Debarment and/or Suspension included as part of this document, and then
such determination may be just cause for disqualification from the evaluation of this bid.
YES
NO
The above signed bidder further affirms and declares that neither the bidder and/or any company official nor any subcontractor to the bidder and/or
any company official has received any notices of debarment and/or suspension from contracting with other states within the United States.
YES
NO
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transactions.
This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR part 3017, Section
3017.510, Participants' responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733).
Instructions for Certification
1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall
attach an explanation to this proposal.
3. By submitting this form, the prospective lower tier participant is providing the certification set forth below in accordance with these instructions.
a. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it
is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including
suspension and/or debarment.
b. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the
prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
c. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary
covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions
and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for
assistance in obtaining a copy of those regulations.
d. The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded
from participation in this covered transaction, unless authorized by the University of Connecticut Health Center.
e. The prospective lower tier participant further agrees by submitting this form that it will include this clause titled "Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
f. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not
debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A
participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not
required to, check the Nonprocurement List.
g. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed
by a prudent person in the ordinary course of business dealings.
h. Except for transactions authorized under paragraph3.(a ) of these instructions, if a participant in a covered transaction knowingly enters into a
lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated
may pursue available remedies, including suspension and/or debarment

YES

NO

If the above signed bidder and/or any company official or any subcontractor to the bidder and/or any company official has received notices of
debarment and/or suspension from contracting with the State of Connecticut, other states within the United States or Federal Government, said
notices must be attached this document when submitted this proposal.
Number of notices attached:

BID PROPOSAL
UCHC 26 REV 12/04

Jennifer K Kelley
Purchasing Services Officer

STATE OF CONNECTICUT

REQUIRED PROPOSAL

UNIVERSITY OF CONNECTICUT HEALTH CENTER

SCHEDULE FORMS

PURCHASING DEPARTMENT MC4036

MUST BE RETURNED

MUNSON ROAD OFFICES
263 Farmington Avenue

860-679-2408

THIS FORM AND

Farmington, CT 06032

Read & Complete
Carefully

Telephone Number

Page 4 of 5
SECTION 4 of 5 : HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
Contractors’ Compliance Certification Regarding Confidentiality and Disclosure of Patient Healthcare Information
Contractor, its agents and employees (collectively, “Contractor”) acknowledge that it may have access to confidential protected health
information (“PHI”), including, but not limited to, patient identifying information. References to PHI include electronic protected health
information (“ePHI”).
Contractor agrees that it:
(a)
will not use or further disclose PHI other than as permitted by this Agreement or required by law as defined in 45 C.F.R. ∫
164.501;
(b)
will protect and safeguard from any oral and written disclosure all confidential information regardless of the type of media on
which it is stored (e.g., paper, fiche, electronic, etc.) with which it may come into contact;
(c)
will use appropriate safeguards to prevent use or disclosure of PHI other than as permitted by this Agreement or required by
law. These safeguards shall include the implementation of administrative, technical and physical safeguards that reasonably
and appropriately protect the confidentiality, integrity, and availability of the ePHI that it creates, receives, maintains or
transmits on behalf of the covered entity;
(d)
will ensure that all of its subcontractors and agents to which it provides PHI pursuant to the terms of this Agreement shall
agree to all of the same restrictions and conditions to which Contractor is bound;
(e)
as soon as the business associate becomes aware it shall report to UCHC any use or disclosure not provided for in by this
Agreement immediately upon becoming aware of it and take prompt corrective action including mitigation and sanction
procedures to cure such unauthorized use or disclosure and execute incident response and reporting procedures;
(f)
will mitigate, to the maximum extent practicable, any harmful effect of a use or disclosure in violation of the requirements of
this Agreement;
(g)
will indemnify and hold UCHC harmless from all liabilities, costs, and damages arising out of or in any manner connected
with the disclosure by Contractor of any PHI;
(h)
will make available PHI in accordance with 45 C.F.R. ∫ 164.524;
(i)
will make available PHI for amendment and incorporate any amendments to PHI in accordance with 45 C.F.R. ∫ 164.526;
(j)
will document disclosures and make available the information required to provide an accounting of disclosure in accordance
with 45 C.F.R. ∫ 164.528;
(k)
will make its internal practices, books, and records relating to the use and disclosure of PHI received from, or created or
received by one party on behalf of the other available to the Secretary of Health and Human Services, governmental officers
and agencies for purposes of determining compliance with 45 C.F.R. ∫ 164.500-534;
(l)
upon termination of this Agreement, for whatever reason, will return or destroy all PHI, if feasible, received from, or created
or received by it on behalf of UCHC, which Contractor maintains in any form, and retain no copies of such information, or if
such return or destruction is not feasible, will inform UCHC of the conditions that make return or destruction infeasible and
extend the precautions of this Agreement to the information and limit further uses and disclosures to those purposes that make
the return or destruction of the information infeasible;
(m)
will have a system of sanctions for any employee, subcontractor or agent who violates this Agreement; and
(n)
will comply with all applicable laws and regulations, specifically including the privacy and security standards of the Health
Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended from time to time.
Contractor recognizes that PHI shall be and remain the property of UCHC and agrees that it acquires no title or rights to PHI, including any
de-identified information, as a result of this Agreement. Contractor further recognizes and agrees that any breach of confidentiality or
misuse of information found in and/or obtained from records may result in the termination of this Agreement and/or legal action, including
reporting to the Secretary of Health and Human Services.
YES (Applicable)

NO (Non-Applicable)

BID PROPOSAL

STATE OF CONNECTICUT

UCHC 26 REV 12/04

UNIVERSITY OF CONNECTICUT HEALTH CENTER

Jennifer K Kelley
Purchasing Services Officer

PURCHASING DEPARTMENT MC4036
MUNSON ROAD OFFICES
263 Farmington Avenue

860-679-2408

THIS FORM AND
REQUIRED
PROPOSAL
SCHEDULE FORMS
MUST BE RETURNED

Farmington, CT 06032

Read & Complete
Carefully

Telephone Number

Page 5 of 5
Section 5 of 5: Notification to Bidders:
Commission on Human Rights and Opportunities Contract Compliance Regulations
The contract to be awarded is subject to contract compliance requirements mandated by Sections 4a-60 and 4a-60a of the Connecticut General Statutes;
and, when the awarding agency is the State, Sections 46a-71 and 46a-81i of the Connecticut General Statutes. There are Contract Compliance
Regulations codified at Section 46a-68j-21 through 43 of the Regulations of Connecticut State Agencies, which establish a procedure for awarding all
contracts covered by Sections 4a-60 and 46a-71 of the Connecticut General Statutes.
According to Section 46a-68j-30(9) of the Contract Compliance Regulations, every agency awarding a contract subject to the contract compliance
requirements has an obligation to “aggressively solicit the participation of legitimate minority business enterprises as bidders, contractors,
subcontractors and suppliers of materials.” “Minority business enterprise” is defined in Section 4a-60 of the Connecticut General Statutes as a business
wherein fifty-one percent or more of the capital stock, or assets belong to a person or persons: “(1) Who are active in daily affairs of the enterprise; (2)
who have the power to direct the management and policies of the enterprise; and (3) who are members of a minority, as such term is defined in
subsection (a) of Section 32-9n.” “Minority” groups are defined in Section 32-9n of the Connecticut General Statutes as “(1) Black Americans . . . (2)
Hispanic Americans . . . (3) persons who have origins in the Iberian Peninsula . . . (4) Women . . . (5) Asian Pacific Americans and Pacific Islanders; (6)
American Indians . . .” An individual with a disability is also a minority business enterprise as provided by Section 4a-60g of the Connecticut General
Statutes. The above definitions apply to the contract compliance requirements by virtue of Section 46a-68j-21(11) of the Contract Compliance
Regulations.
The awarding agency will consider the following factors when reviewing the bidder’s qualifications under the contract compliance requirements:
(a) the bidder’s success in implementing an affirmative action plan;
(b) the bidder’s success in developing an apprenticeship program complying with Sections 46a-68-1 to 46a-68-17 of the Administrative
Regulations of Connecticut State Agencies, inclusive;
(c) the bidder’s promise to develop and implement a successful affirmative action plan;
(d) the bidder’s submission of employment statistics contained in the “Employment Information Form”, indicating that the composition of its
workforce is at or near parity when compared to the racial and sexual composition of the workforce in the relevant labor market area;
(e) and the bidder’s promise to set aside a portion of the contract for legitimate minority business enterprises. See Section 46a-68j-30(10)(E) of the
Contract Compliance Regulations.
The above-signed individual acknowledges reading the above Notification to Bidders.

Employment Information Form
BIDDER/CONTRACTOR

STATE OF CONNECTICUT
COMMISSION ON HUMAN RIGHTS & OPPORTUNITIES
WORKFORCE ANALYSIS AFFIRMATIVE ACTION REPORT
CONTACT PERSON:

ADDRESS

DATE:
PHONE NUMBER

CONTRACT AWARD NUMBER
4-1599
Report all permanent full-time or part-time employees, including apprentice and on-the-job trainees. Enter the numbers on all lines and in all columns.
OVERALL TOTALS
A
B
C
D
E
JOB
(Sum of all Columns,
WHITE (NOT OF
BLACK (NOT OF
ASIAN OR
AMER. INDIAN OR
CATEGORIES
A thru F
HISPANIC ORIGIN)
HISPANIC ORIGIN)
HISPANIC
PACIFIC ISLANDER
ALASKAN NATIVE
Male and Female)
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
Officials and
Managers
Professionals
Technicians
Sale Workers
Office and
Clerical
Craft Workers
(Skilled)
Operatives
(Semi-skilled)
Laborers
(Unskilled)
Service
Workers
TOTALS
ABOVE
Do you use minority businesses as subcontractors or suppliers?

YES

NO

If CT based, do you post all employment openings with the State of Connecticut
Employment Service?

YES

NO

Do you implement a written Affirmative Action Plan?

YES

NO

Explain:
Explain:
Explain:

DESCRIBE YOUR RECRUITMENT, HIRING, TRAINING AND PROMOTION ANTI DISCRIMINATION PRACTICES

UCHC-45 Rev. 12/04

INVITATION TO BID
UCHC-19 Rev. 12/04
Jennifer K Kelley
Purchasing Services Officer

STATE OF CONNECTICUT
UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Administrative Services Building 1st Floor
263 Farmington Avenue
Farmington CT 06032

860-679-2408
Telephone Number
All Invitations to Bid issued by the University of Connecticut Health
Center Purchasing Department will bind Bidders to the terms and
conditions listed below, unless specified otherwise in any individual
Invitations to Bid.
Incorporated by reference into this contract are applicable
provisions of the Connecticut General Statutes including but not
limited to Sections 10a-151b, 4a-50 through 4a-80, and applicable
provisions of the Regulations of Connecticut State Agencies
including but not limited to Sections 4a-52-1 through 4a-52-22.
The contractor agrees to comply with the statutes and
regulations as they exist on the date of this contract and as they may
be adopted or amended from time to time during the term of this
contract and any amendments thereto.
Submission of Bids
1.
Bids must be submitted on forms supplied by Purchasing
Department. Telephone or facsimile bids will not be accepted in
response to an Invitation to Bid.
2.
The time and date bids are to be opened is given in each bid issued.
Bids received after the specified time and date of bid opening given in
each bid proposal shall not be considered. Bid envelopes must clearly
indicate the bid number as well as the date and time of the opening of
the bid. The name and address of the Bidder should appear in the upper
left hand corner of the envelope.
3.
Incomplete bid forms may result in the rejection of the bid.
Amendments to bids received by Purchasing Department after the time
specified for opening of bids, shall not be considered. An original and
one copy of the proposal schedule shall be returned to Purchasing
Department. Bids shall be computer prepared, typewritten or
handwritten in ink. Bids submitted in pencil shall be rejected. All bids
shall be signed by a person duly authorized to sign bids on behalf of the
bidder. Unsigned bids shall be rejected. Errors, alterations or corrections
on both the original and copy of the proposal schedule to be returned
must be initialed by the person signing the bid proposal or their
authorized designee. In the event an authorized designee initials the
correction, there must be written authorization from the person signing
the bid proposal to the person initialing the erasure, alterations, or
correction. Failure to do so shall result in rejection of bid for those items
erased, altered or corrected and not initialed.
4.
Conditional bids are subject to rejection in whole or in part. A
conditional bid is defined as one, which limits, modifies, expands or
supplements any of the terms and conditions and/or specifications of the
Invitations to Bid.
5.
Alternate bids will not be considered. An alternate bid is defined as
one, which is submitted in addition to the bidder’s primary response to
the Invitations to Bid.
6.
Prices should be extended in decimal, not fraction, to be net, and
shall include transportation and delivery charges fully prepaid by the
Contractor to the destination specified in the bid, and subject only to
cash discount.
7.
Pursuant to Section 12-412 of the Connecticut General Statutes,
the State of Connecticut is exempt from the payment of excise,
transportation and sales taxes imposed by the Federal Government
and/or the State. Such taxes must not be included in bid prices.
8.

In the event of a discrepancy between the unit price and the

Bid Number:

4-1599

Page 1 of 3
extension, the unit price shall govern.
9.
By its submission the Bidder represents that the bid is not made in
connection with any other Bidder submitting a bid for the same
commodity or commodities and is in all respects fair and without
collusion or fraud.
10. All bids will be opened and read publicly and upon award are
subject to public inspection.
Guaranty or Surety
11. Bid and or performance bonds may be required. Bonds must meet
the following requirements: Corporation - must be signed by an official
of the corporation above their official title and the corporate seal must be
affixed over the signature; Firm or Partnership - must be signed by all
the partners and indicate they are “doing business as”; Individual - must
be signed by the owner and indicated as “Owner”. The surety company
executing the bond or countersigning must be licensed in Connecticut
and the bond must be signed by an official of the surety company with
the corporate seal affixed over their signature. Signatures of two
witnesses for both the principal and the surety must appear on the bond.
Power of attorney for the official signing the bond for the surety
company must be submitted with the bond.
Samples
12. Accepted bid samples do not supersede specifications for quality
unless sample is superior in quality. All deliveries shall have at least the
same quality as the accepted bid sample.
13. Samples are furnished free of charge. Bidder must indicate if their
return is desired, provided they have not been made useless by test.
Samples may be held for comparison with deliveries.
Award
14. Award will be based on quality of the articles or services to be
supplied, their conformance with specifications, delivery terms, price,
administrative costs, past performance, and financial responsibility.
15. Purchasing Department may reject any bidder in default of any
prior contract or guilty of misrepresentation or any bidder with a
member of its firm in default or guilty of misrepresentation.
16. Purchasing Department may correct inaccurate awards resulting
from clerical or administrative errors.
Contract
17. The existence of the contract shall be determined in accordance
with the requirements set forth above. However, the award of the
contract is not an order to ship.
18. The Contractor shall not assign or otherwise dispose of their
contract or their right, title or interest, or their power to execute such
contract to any other person, firm or corporation without the prior written
consent of the Purchasing Department.
19. Bidders have ten days after notice of award to refuse acceptance of
the award; after ten days the award will be binding on the Contractor. If
the Contractor refuses to accept the award within the ten-day period, the
award will be made to the next lowest responsible qualified bidder.
20. Failure of a Contractor to deliver commodities or perform services
as specified will constitute authority for Purchasing Department to
purchase these commodities or services on the open market. The
Contractor agrees to promptly reimburse the State for excess cost of

INVITATION TO BID
UCHC-19 Rev. 12/04
Jennifer K Kelley
Purchasing Services Officer

STATE OF CONNECTICUT

Bid Number:

UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Administrative Services Building 1st Floor
263 Farmington Avenue
Farmington CT 06032

860-679-2408
Telephone Number

4-1599

Page 2 of 3

these purchases. The purchases will be deducted from the contracted
quantities. Rejected commodities must be removed by the Contractor
from State premises within 48 hours. Immediate removal may be
required when safety or health issues are present

Rights
30. The State has sole and exclusive right and title to all printed
material produced for the State and the contractor shall not copyright the
printed matter produced under the contract.

21. Contractor agrees to: hold the State harmless from liability of any
kind for the use of any copyright or uncopyrighted composition, secret
process, patented or unpatented invention furnished or used in the
performance of the contract; guarantee their products against defective
material or workmanship; repair damages of any kind, for which they
are responsible to the premises or equipment, to their own work or to the
work of other contractors; obtain and pay for all licenses, permits, fees
etc. and to give all notices and comply with all requirements of city or
town in which the service is to be provided and to the State of
Connecticut; to carry proper insurance to protect the State from loss.

31. The Contractor assigns to the State all rights title and interests in
and to all causes of action it may have under Section 4 of the Clayton
Act, 15 USC 15, or under Chapter 624 of the general statutes. This
assignment occurs when the Contractor is awarded the contract.

22. Notwithstanding any provision or language in this contract to the
contrary, the Commissioner may terminate this contract whenever he/she
determines in his/her sole discretion that such termination is in the best
interests of the State. Any such termination shall be effected by delivery
to the Contractor of a written notice of termination. The notice of
termination shall be sent by registered mail to the Contractor address
furnished to the State for purposes of correspondence or by hand
delivery. Upon receipt of such notice, the Contractor shall both
immediately discontinue all services affected (unless the notice directs
otherwise) and deliver to the State all data, drawings, specifications,
reports, estimates, summaries, and such other information and materials
as may have been accumulated by the Contractor in performing his
duties under this contract, whether completed or in progress. All such
documents, information, and materials shall become the property of the
State. In the event of such termination, the Contractor shall be entitled to
reasonable compensation as determined by the Commissioner of the
Department of Administrative Services; however, no compensation for
lost profits shall be allowed.

33. All purchases will be in compliance with Section 22a-194 to
Section 22a-194g of the Connecticut General Statutes related to product
packaging. This contract is subject to the provisions of the following
executive orders:

Delivery
23. All products and equipment delivered must be new unless
otherwise stated in the bid specifications.
24. Delivery will be onto the specified State loading docks by the
Contractor unless otherwise stated in the bid specifications.
25. Deliveries are subject to re-weighing on State sealed scales.
26. Payment terms are net 30 days after receipt of goods or invoice,
whichever is later, unless otherwise specified.
27. Charges against a Contractor shall be deducted from current
obligations. Money paid to the State by the Contractor shall be payable
to the Treasurer, State of Connecticut.
Saving Clause
28. The Contractor shall not be liable for losses or delays in the
fulfillment of the terms of the contract due to wars, acts of public
enemies, strikes, fires, floods, acts of God or any other acts not within
the control of or reasonably prevented by the Contractor. The Contractor
will give written notice of the cause and probable duration of any such
delay.
Advertising
29. Contractors may not reference sales to the State for advertising and
promotional purposes without the prior approval of Purchasing
Department.

32. Contractor agrees that it is in compliance with all applicable
federal, state and local laws and regulations, including but not limited to
Connecticut General Statutes Sections 4a-60 and 4a-60a. The Contractor
also agrees that it will hold the State harmless and indemnify the State
from any action which may arise out of any act by the contractor
concerning lack of compliance with these laws and regulations.

Executive Order No. Three of Governor Thomas J. Meskill promulgated
June 16, 1971 requires nondiscrimination clauses in state contracts.
Executive Order No. Seventeen of Governor Thomas J. Meskill
promulgated February 15, 1973 requires contractors and subcontractors
having a contract with the state or any business entity having business
with the state or which seeks to do business with the state, and every
bidder or prospective bidder who submits a bid or replies to an invitation
to bid on any state contract shall list all employment openings with the
office of the Connecticut State Employment Service..
Executive Order No. Sixteen of Governor John G. Rowland promulgated
August 4, 1999 regarding Violence in the Workplace Prevention Policy
Executive Order No. 7B of Governor M. Jodi Rell promulgated January
1, 2006 establishes the State Contracting Standards Board to address the
state’s vulnerabilities in the selection and procurement processes to
avoid improprieties, favoritism, unfair practices or ethical lapses in state
contracting.
Records, Files, and Information
34. Incorporated by reference into this contract and Pursuant to Public
Act No. 01-169, each contract in excess of two million five hundred
thousand dollars between a public agency and a person for the
performance of a governmental function shall (1) provide that the public
agency is entitled to receive a copy of records and files related to the
performance of the governmental function, and (2) indicate that such
records and files are subject to the Freedom of Information Act and may
be disclosed by the public agency pursuant to the Freedom of
Information Act.
35. Incorporated by reference into this contract is Section 4-61dd(g)(1)
and 4-61dd(3) and (f) of the Connecticut General Statutes which
prohibits contractors from taking adverse action against employees who
disclosed information to the Auditors of Public Accounts or the Attorney
General.
Dispute Resolution
36. Contractor may bring claims against Customer for any loss, claim,
damage, or liability of whatsoever kind or nature, which may arise from
or in connection with this Agreement in accordance with Chapter 53 of
the Connecticut General Statutes. Contractor shall have recourse through

INVITATION TO BID
UCHC-19 Rev. 12/04
Jennifer K Kelley
Purchasing Services Officer

STATE OF CONNECTICUT
UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Administrative Services Building 1st Floor
263 Farmington Avenue
Farmington CT 06032

860-679-2408
Telephone Number
the State of Connecticut Claims Commission as provided under Chapter
53 of the Connecticut General Statutes in which all claims against the
State of Connecticut and the University of Connecticut Health Center
will be filed with Connecticut's Claims Commissioner. The parties agree
that if such claim is not resolved by the State of Connecticut Claims
Commission, then the venue for any the litigation resulting out of any
controversy or claim against Customer arising out of or relating to this
Agreement, or the breach thereof, shall be the state courts of Connecticut
or the federal courts sitting in Connecticut. Each party hereby
irrevocably waives the right to trial by jury in any federal or state
judicial proceeding. Each party hereby waives any right to seek punitive,
exemplary, multiplied or consequential damages, prejudgment interest or
attorneys' fees or costs.
John Dempsey Hospital Policies and Procedures
37. Contractor will comply with John Dempsey Hospital policies and
procedures, as well as all applicable laws, ordinances, rules regulations,
standards, and orders of governmental, regulatory and accrediting
bodies, including but not limited to the Joint Commission on the
Accreditation of Health Care Organizations (JCAHO), having
jurisdiction in the premises that are applicable to the conduct of
physicians.

Page 3 of 3

Bid Number:

4-1599

INVITATION TO BID
UCHC-14 Rev. 10/03

Jennifer K Kelley

STATE OF CONNECTICUT

BID Number:

UNIVERSITY OF CONNECTICUT HEALTH CENTER

4-1599

BIDDERS STATEMENT OF QUALIFICATIONS

Purchasing Services Officer

860-679-2408
Telephone Number

Page 1 of 2

This form will be used in assessing a bidder’s qualifications and to determine if the bid submitted is from a responsible
bidder. State law designates that contracts be awarded to the lowest responsible qualified bidder. Factors such as past
performance, integrity of the bidder, conformity to the specifications, etc. Will be used in evaluating bids. Attach additional
sheets if necessary.
COMPANY NAME:
ADDRESS:

Number of years company has been engaged in business under this name:
List other names your company goes by:
1.

2.

List previous company name (s):
1.

2.

Years

Size of Company, Firm, or Corporation
Number of Employees:
Company Value:

Full Time:
Equipment Assets:

Part-Time:
Total Assets:

Is your company registered with the Office of the Connecticut Secretary of State?

Yes

No

If requested, would your company provide a “Good Standing” certificate issued by the Connecticut Secretary of State?
Yes
No
List any relevant certifications, licenses, registrations, etc., which qualify your company to meet the requirements of this bid:

List of Equipment to be used for this service (include model, year, and manufacturer):
Model

Year

Manufacturer

INVITATION TO BID
UCHC-14 Rev. 10/03

Jennifer K Kelley
Purchasing Services Officer

STATE OF CONNECTICUT

BID Number:

UNIVERSITY OF CONNECTICUT HEALTH CENTER

4-1599

BIDDERS STATEMENT OF QUALIFICATIONS

860-679-2408
Telephone Number
Page 2 of 2
List any contract awards to your company within the last three years. Indicate which State agency, and provide contract
name and number, and the Purchasing Agent administering the contract:
Contract No.:

Contract No.:

Contract Name:

Contract Name:

State Agency:

State Agency:

Purchasing Agent:

Purchasing Agent:

Tel. No.:

Tel. No.:

Effective Dates:

Effective Dates:

Contract No.:

Contract No.:

Contract Name:

Contract Name:

State Agency:

State Agency:

Purchasing Agent:

Purchasing Agent:

Tel. No.:

Tel. No.:

Effective Dates:

Effective Dates:

List any criminal convictions against your company and any of your company’s officers, principal shareholders, directors, partners, LLC
members and LLC managers:
(Attach additional sheets, if necessary )
List any administrative actions either pending review by the state or determinations that the state has made regarding your company or any
of your company’s officers, principal shareholders, directors, partners, LLC members or LLC managers. This would include court
judgments, actions, suits, claims, demands, investigations and legal, administrative or arbitration proceedings pending in any forum.
Include a listing of OSHA violations and any actions or orders pending or resolved with any state agency such as the department of
consumer protection, the department of environmental protection, etc. Detail this information on a separate sheet of paper. Such
information should be for the last three (3) years.
(Attach additional sheets, if necessary )

I hereby certify under penalty of false statement that all the information supplied is complete and true.

Signature
Title

Date

REQUEST FOR PROPOSAL

UCHC-30 Rev. 12/04
Jennifer K. Kelley
Purchasing Agent

STATE OF CONNECTICUT

Bid/RFP Number:

UNIVERSITY OF CONNECTICUT HEALTH CENTER
PURCHASING DEPARTMENT
Munson Road Offices
263 Farmington Avenue
Farmington CT 06032

4-1599

860-679-1988
Telephone Number

Certification Requirements for State Contracts
The University of Connecticut adheres to the State of Connecticut Office of Policy
and Management policies and guidelines regarding Certification Requirements for
State Contracts.
State contracts
State contracts with
State contracts with a cost* to the
with a value* less a value* of $50,000
State greater than $500,000
than $50,000
or more
Gift Certification

No

Form 1

Form 1

Campaign Contribution
Certification

No

Form 2

Form 2

Agency Certification

No

Form 3

Form 3

Annual Contract
Certification

No

Form 4

Form 4

No

Form 5
(Only to be used
with contracts for
the purchase of
goods and services)

Form 5
(Only to be used with contracts
for the purchase of goods and
services)

No

Form 6 (A, B, C)
(Only to be used with large state
construction or procurement
contracts as defined in §32 of
Public Act 05-287)

Consulting Agreement
Affidavit

Affirmation of Receipt
of Summary of State
Ethics Laws

No

Grant awards are not:
● ‘large state contracts’ as defined by Conn. Gen. Stat. § 4-250;
● ‘State Contract’ as defined by Executive Order 7C, para 2; or
● ‘contracts for the purchase of goods and services’ as used in Conn. Gen. Stat. § 4a-81.
* The “value of the contract” means the dollar amount or equivalent benefit expended or received by
the State in accordance with the contract; whereas, the “cost to the State for a contract” means the
dollar amount or equivalent benefit expended by the State in accordance with the contract.

FORM 1
Revised 7/01/06

STATE OF CONNECTICUT
OFFICE OF POLICY AND MANAGEMENT
Policies and Guidelines

GIFT CERTIFICATION
Gift certification to accompany State Contracts with a value of $50,000 or more in a calendar or fiscal
year, pursuant Conn. Gen. Stat. §§ 4-250 and 4-252, and Governor M. Jodi Rell’s Executive Order No.
7C, para. 10.
I, ________________________________________________(Type/Print Name, Title and
Name of Firm or Corporation), am authorized to execute the attached contract on behalf of
______________________________________(the Name of Firm or Corporation) (the “Contractor”).
I hereby certify that between ___________ (mm/dd/yy) (planning date) and __________ (mm/dd/yy)
(date of the execution of the attached contract) that neither I, myself, the Contractor, nor any of its
principals or key personnel who participated directly, extensively and substantially in the preparation
of the bid or proposal (if applicable) or in the negotiation of this contract, nor any agent of the above,
gave a gift, as defined in Conn. Gen. Stat. § 1-79(e), including a life event gift as defined in Conn.
Gen. Stat. § 1-79(e)(12), to (1) any public official or state employee of the contracting state agency or
quasi-public agency who participated directly, extensively, and substantially in the preparation of the
bid solicitation or request for proposals for the contract (if applicable) or in the negotiation or award of
this contract; or (2) any public official or state employee of any other state agency who has
supervisory or appointing authority over the state agency or quasi-public agency executing this
contract, except the gifts listed below:
Name of Benefactor
List information here

Name of recipient

Gift Description

Value

Date of Gift

Further, neither I nor any principals or key personnel of the Contractor, nor any agent of the
above, knows of any action by Contractor to circumvent such prohibition on gifts by providing for any
other principals, key personnel, officials, employees of Contractor, nor any agent of the above, to
provide a gift to any such public official or state employee.
Further, the Contractor made its bid or proposal without fraud or collusion with any person.
Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement.
_________________________________
Signature

_____________________________________
Date

Sworn and subscribed before me on this_____________ day of ________________, 200__
________________________________________
Commissioner of the Superior Court
Notary Public

FORM 2

STATE OF CONNECTICUT
OFFICE OF POLICY AND MANAGEMENT
UNIVERSITY OF CONNECTICUT HEALTH CENTER
Policies and Guidelines

Campaign Contribution Certification
Campaign contribution certification to State Contracts with a value of $50,000 or more
in a calendar or fiscal year, pursuant to Conn. Gen. Stat. § 4-250 and Governor M. Jodi
Rell’s Executive Order No. 1, para 8. and No. 7C, para 10.
I, _____________________________________________ (Type/Print Name, Title and Name of Firm
or Corporation), hereby certify that during the two-year period preceding the execution of the attached contract,
neither myself nor any principals or key personnel of the _______________________________ (Name of Firm
or Corporation) who participated directly, extensively and substantially in the preparation of the bid or proposal
(if applicable) or in the negotiation or award of this contract, nor any agent of the above, gave a contribution to
a candidate for statewide public office or the General Assembly, as defined in Conn. Gen. Stat. §9-333b, except
as listed below:
Contributor

Recipient

Amount/Value

Date of Contribution

Contribution Description

List information here

Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement.

Signature
Sworn and subscribed before me on this

Date
day of

200

Commissioner of the Superior Court
Notary Public

Form 5

STATE OF CONNECTICUT
OFFICE OF POLICY AND MANAGEMENT
UNIVERSITY OF CONNECTICUT HEALTH CENTER
Policies and Guidelines

Consulting Agreement Affidavit
Consulting agreement affidavit to accompany state contracts for the purchase of goods and
services with a value of $50,000 or more in a calendar or fiscal year, pursuant to Section
51 of Public Act 05-287.
This affidavit is required if a bidder or vendor has entered into any consulting agreements whereby the duties of the
consultant include communications concerning business of such state agency, whether or not direct contact with a state
agency, state or public official or state employee was expected or made. Pursuant to Section 51 of P.A. 05-287, "consulting
agreement" means any written or oral agreement to retain the services, for a fee, of a consultant for the purposes of (A)
providing counsel to a contractor, vendor, consultant or other entity seeking to conduct, or conducting, business with the
State, (B) contacting, whether in writing or orally, any executive, judicial, or administrative office of the State, including any
department, institution, bureau, board, commission, authority, official or employee for the purpose of solicitation, dispute
resolution, introduction, requests for information or (C) any other similar activity related to such contract. Consulting
agreement does not include any agreements entered into with a consultant who is registered under the provisions of chapter
10 of the general statutes as of the date such affidavit is submitted in accordance with the provisions of this section.

I, __________________________________________, hereby swear that I am the chief official of the
bidder or vendor of the Contract or authorized to execute such Contract. I further swear that I have not entered
into any consulting agreement in connection with such contract, except the agreements listed below:
Contractor’s Name, Title and Firm or Corporation: ____________________________________
_____________________________________________________________________________
Terms of Consulting Agreement (Date of Execution, Amount, Expiration Date): ____________
Brief Description of Services Provided (Purpose, Scope, Activities, Outcomes): _____________
_____________________________________________________________________________
Yes

No

Is the Consultant a former state employee or public official?

If yes, provide the following information about the former state employee or public official:
•
Former Agency: ____________________________________________________
•
Date Such Employment Terminated: __________________
Attach additional sheets if necessary. This affidavit must be amended if Contractor
enters into any new consulting agreements during the term of this Contract
Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement.

Signature
Sworn and subscribed before me on this

Date
day of
Commissioner of the Superior Court/or
Notary Public

2006

BID Number:

State of Connecticut
UCHC-16 Rev. 12/04
Jennifer K Kelley
Purchasing Services Officer

UNIVERSITY OF CONNECTICUT HEALTH CENTER

Proposal Schedule

4-1599
Delivery:
Terms:

860-679-2408
Telephone Number

IMPORTANT!
RETURN ORIGINAL AND ONE COPY

Cash Discount:
%

# Days

Bidder Name:
Payment terms are net 30 days after receipt of invoice. Any deviation may result in bid
rejection. Bid prices shall include all transportation charges FOB UConn Health Center.

SSN or FEIN #:

Proposal Schedule Page 1 of 2
ITEM
NO.

DESCRIPTION OF COMMODITIES AND/OR SERVICES

QUAN.

UNIT

UNIT PRICE

TOTAL PRICE

Provide Backflow Device Testing & Repair for
the period through June 30, 2007, with the
option to renew for two additional 1-year
periods at the discretion of the UCHC.
This bid is for the testing of domestic hot and
cold water backflow devices as required by
MDC. Backflow preventers are located at the
University of Connecticut Health Center Main
Campus at 263 Farmington Avenue or Campus
C at 16 Munson Road, Farmington, CT. The
1¼” and larger backflow devices are located in
mechanical rooms while the 1” and smaller
backflow devices are located in corridors and
laboratories. Contractors with experience in
repairs should have a good idea of the
problems and costs associated with each repair
for each size backflow. Contractor should have
a full repair kit available for each size backflow
when he performs the testing for that size. An
electronic file of all backflows by size, location,
date of installation, past records, and model
numbers can be provided to the contractor. All
backflows are "Watts" and most of them are
model 909 or 009. Testing can be done during
normal working hours
Below is a listing of the approximate number of
each size backflow preventer. Please provide a
price for testing of each size backflow preventer
and the repair of same if repair is required.
1

Size
6”

Number of Units
12

Testing Unit
Price
$________

Repair Unit
Price
$________

2

4”

4

$________

$________

BID Number:

State of Connecticut
UCHC-16 Rev. 12/04
Jennifer K Kelley
Purchasing Services Officer

UNIVERSITY OF CONNECTICUT HEALTH CENTER

Proposal Schedule

4-1599
Delivery:
Terms:

860-679-2408
Telephone Number

IMPORTANT!
RETURN ORIGINAL AND ONE COPY

Cash Discount:
%

# Days

Bidder Name:
Payment terms are net 30 days after receipt of invoice. Any deviation may result in bid
rejection. Bid prices shall include all transportation charges FOB UConn Health Center.

SSN or FEIN #:

Proposal Schedule Page 2 of 2
ITEM
NO.

DESCRIPTION OF COMMODITIES AND/OR SERVICES

QUAN.

UNIT

UNIT PRICE

TOTAL PRICE

3

3”

15

$________

$________

4

2”

14

$________

$________

5

1½”

15

$________

$________

6

1¼”

10

$________

$________

7

1”

10

$________

$________

8

¾”

120

$________

$________

9

½”

900

$________

$________

Notes:
1. To schedule a site visit if desired, please
contact Dennis Scranton at 860-679-2333.
2. Preference will be given to State of
Connecticut Certified Small or Minority
Businesses. Please include a copy of your
certificate with your bid if you fall into this
category. If no responses are received from
set-aside businesses, award will be made to
the lowest responsive and responsible
bidder.
3. All testers must be certified by the State of
Connecticut. Please provide evidence of
certification with your bid.
Direct all questions via email to:
Jennifer Kelley
Purchasing Services Officer
email: jkk1011@adp.uchc.edu
Phone: 860-679-1988



---

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