Owl Canyon/CR 70 Road Reconstruction

INVITATION TO BID
ITB #B26-04
Owl Canyon/CR 70 Road Reconstruction (CR 11 to CR 13)(PN 329)
ITB SUMMARY:
The work consists of reconstructing one (1) mile of CR 70 (Owl Canyon Road) between CR 11 and CR
13 northwest of Wellington.
FHWA 1273 Required Contract Provisions; Contract Provisions for Non-Federal Entity Contracts
Under Federal Awards; Appendices A and E to Larimer County Title VI Plan; and Highway Davis
Bacon Wage Determination CO20260014 MOD1, 05/18/2026.
All bidders shall be listed on CDOT's current General Prime Contractors List. All bidders shall be
experienced highway contractors and must be experienced in highway construction and in the use of
the Colorado Department of Transportation's Specifications for Road and Bridge Construction.
PRE-BID MEETING: August 26, 2026 @ 1:00 PM (MT)
A VIRTUAL Pre-bid Conference will be held. Representatives of Larimer County will be present to
discuss the project and answer questions. Any interested Bidders and subcontractors are requested
(not required) to attend and participate in the conference. Those intending to bid should read the entire
bid document prior to the meeting.
To attend virtually use the following Zoom link:
https://larimer-org.zoom.us/j/93250487696?pwd=SW44K0txV0p6RnBZamtseWlmWU4vUT09
Meeting ID: 932 5048 7696 Passcode: 630586
One tap mobile: +13462487799,,93250487696#,,,,*630586# US
Dial by Phone: +1 346 248 7799
TO ATTEND THE VIRTUAL PRE-BID MEETING:
https://larimer-org.zoom.us/j/95433826086?pwd=y1l1iOCvo1APbntwbcPsKu9yX5ao9R.1
Join by Phone: +1 346 248 7799 US or One tap mobile +13462487799,,95433826086#,,,,*963316# US
Meeting ID: 954 3382 6086 Passcode: 963316
QUESTION DEADLINE: September 3, 2026 @ 10:00 a.m. (MT)
All questions regarding this solicitation must be emailed to the Contact Person identified below. Please
email inquires anytime through the deadline. If you do not receive a confirmation email of receipt, please
call the number below to verify receipt of your questions. No questions will be accepted after the date
and time referenced above. All questions received will be answered via Addendum on BidNet only.
DEADLINE FOR SUBMITTALS/BID OPENING: September 9, 2026 @ 2:00 p.m. (MT)
The Board of Larimer County Commissioners will only be accepting Bids electronically submitted via the
Rocky Mountain E-Purchasing System (BidNet SOVRA) portal, up to the date and time referenced
above, at which time they will be publicly opened and read aloud.
TO ATTEND THE VIRTUAL BID OPENING:
https://larimer-org.zoom.us/j/95042236437?pwd=Sh8yVkel0RAKgfAg4FqpxuSotuY1Am.1
Join by Phone: +1 646 931 3860 or One tap mobile +16469313860,,95042236437#,,,,*170350# US
Meeting ID: 950 4223 6437 Passcode: 170350
BIDNET PORTAL / ITB OFFICIAL WEBSITE:
To submit your bid and view official solicitation documents and addenda only available on the BidNet
portal, use the following link: https://www.bidnetdirect.com/colorado/larimer-county/
CONTACT PERSON:
Purchasing Agent Sarah Brightman, brightss@co.larimer.co.us, 970-498-5956
B26-04 1 of 6

NOTE: Unauthorized contact with consultants Short Elliott & Hendrickson, Inc. (SEH) or any County
employee, other than the Contact Person listed above or Purchasing Manager, regarding this bid may
result in disqualification of your bid.
1. GENERAL INSTRUCTIONS FOR BIDDERS:
1.1 Artificial Intelligence (AI) Disclosure:
Portions of this solicitation may have been prepared or modified with the assistance of Artificial Intelligence (AI)
technologies. All such content has been reviewed, verified, and approved for accuracy and compliance by the
Purchasing Agent prior to issuance.
1.2 Bid Preparation:
Bidders are responsible for all costs associated with preparing and submitting their bid. Bids must be completed
in ink or typewritten on County-provided forms and must not include conditions outside the specifications unless
specifically requested. Non-conforming bids may be rejected. All bid prices must be furnished exclusive of
Federal, State, and Local taxes.
1.3 Bid Submission:
Bidders must be registered with BidNet in order to submit a bid; registration is free. Larimer County strongly
recommends bidders register well in advance of the submittal deadline to ensure they have adequate time to
upload and submit their bid.
It is the sole responsibility of the Bidder to ensure all required Bid documents are submitted through BidNet by
the submission deadline. Bids will be time-stamped by BidNet upon receipt; BidNet does not allow for uploading
or submitting Bid documents after the Bid submittals deadline has passed, so allow adequate time to upload and
submit your Bid prior to the deadline. Larimer County will not accept uploads that are "saved" but not
"submitted". To verify that a Bid has been submitted successfully, Bidders may contact BidNet Support, or
verify, via the Bid Management tab in the Bidder's account, that the documents are not in "Draft" status.
1.4 Consideration of Bids:
It is understood that Larimer County reserves the right to reject any and/or all bids and to waive informalities and
irregularities in bids, and to accept the bid that, in the opinion of Larimer County, is in the best interests of
Larimer County. No bid is contingent on the purchase of all items listed. Prices and terms must remain in
effect until a contract has been executed.
If, in the sole judgment of the Board of County Commissioners, the bids are substantially equal, the Board may
grant the contract to a company(ies) located in Larimer County, however this is not applicable in the case that
Federal funds are used.
1.5 Cooperative Use
Other governmental entities may piggyback on the award of this solicitation, assuming the award vendor is
amenable, and should contact Larimer County Purchasing for any necessary procurement documents. The
entity will deal directly with the award vendor concerning the placement of Purchase Orders, freight charges,
contracting and disputes, invoicing, and payment. Larimer County will not be held liable or responsible for any
liability, claims, costs, damages, demands, actions, losses, judgments or expenses incurred by the vendor or
any government entity relating to such use.
1.6 Equal Opportunity Employer (EEO) / Disadvantaged Business Opportunities:
Larimer County, in accordance with Federal and State laws, is an Equal Opportunity Employer and does not
discriminate. Larimer County strongly encourages the use of small and minority firms, women's business
enterprises, and labor surplus area firm services.
Larimer County hereby notifies all Bidders they will be afforded full and fair opportunity to submit a Bid in
response to this ITB and they will not be discriminated against on the basis of age 40 and over, race, sex
(including pregnancy), color, religion, national origin, disability, genetic information, sexual orientation, gender
identity, gender expression, military or veteran status, or any other applicable status protected by Federal, State,
or local law in consideration for award.
B26-04 2 of 6

1.7 Payment:
Payment for work performed or goods sold to Larimer County can be expected within 45 days after receipt of the
invoice and satisfactory acceptance by the Department receiving the service or goods (unless otherwise stated
and agreed to by County).
1.8 Public Records:
All information submitted in response to this bid is subject to disclosure under the Colorado Open Records Act
("CORA").
1.9 Insurance:
Upon Notice of Award, the Award Vendor will be required to submit a valid Certificate of Insurance (COI) that
meets, at a minimum, the Insurance Requirements published in this bid solicitation, see Contract Attachment B
- Insurance Requirements published as a separate attachment with this invitation to bid. This valid COI must
be received by Larimer County within 10 calendar days of the Notice of Award and must include Larimer County
listed as Additional Insured and Certificate Holder.
1.10 Accessibility
1.10.1 Reasonable Accommodations: Per the Americans with Disabilities Act (ADA), Larimer County
will provide reasonable accommodation to qualified individuals with a disability who need assistance.
Services can be arranged with at least seven (7) business days' notice. Please email the Contact Person
listed on the page 1 or call Relay Colorado 711. "Walk-in" requests for auxiliary aids and services will be
honored to the extent possible but may be unavailable if advance notice is not provided.
1.10.2 Notice Regarding Sample Contract Documents: The sample contract, insurance requirements,
and payment and performance (P&P) bonds in this package (Attachment B) are standardized legal forms
and schedules. These documents contain specialized formatting, multi-column tables, Davis-Bacon wage
determinations, and dense legal language that may not be fully accessible to screen readers or other
assistive technologies.
1.10.3 Notice Regarding Third-Party Document Accessibility: The documents in Attachment D -
CDOT Special Provisions are the property of the Colorado Department of Transportation (CDOT) and are
hosted in this bid package for project compliance and information. Because these documents were
authored by an external state agency, they may not be fully accessible to screen readers or other
assistive technologies. To view the original source documents or request native files, please visit the web
site:
https://www.codot.gov/business/designsupport/cdot-construction-specifications/2025-construction-
specifications.
1.10.4 Notice Regarding Plan Documents: The engineering drawings in this package (Attachment E)
are technical visual representations intended for construction purposes and may not be optimized for
screen readers or other assistive technologies.
1.10.5 Notice Regarding Geotechnical Report: The geotechnical report included in this package
(Attachment F) is a technical document prepared by a third-party consultant and contains specialized
formatting, calculations, soil logs, and graphic depictions that may not be fully accessible to screen
readers or other assistive technologies.
1.10.6 Notice Regarding Project Cad Files & Data Availability: Larimer County has made project CAD
files available for download from a Google Drive:
https://drive.google.com/drive/folders/1JSdWAk1b1qsF7oQGc5HdKkeywkL49lsD?usp=sharing
(This link is also provided separately within the BidNet document portal.) These CAD files contain
finished grade and existing ground surface information, as well as existing and proposed roadway
linework. Raw CAD spatial data requires specialized design software and is not fully compatible with
screen readers or assistive technologies.
1.10.7. As-Is, No Warranty: The following legal disclaimer applies for any and all use of these project
CAD/Data files: Data files transmitted are provided strictly as a courtesy and possible convenience. Short
Elliott & Hendrickson, Inc. (SEH) and Larimer County assume no responsibility for loss or damages
B26-04 3 of 6

resulting from the use of any information, apparatus, product, or process referenced here. The users of
the electronic data shall indemnify and hold SEH and Larimer County harmless from and against any and
all damages, liabilities, losses, costs, and/or expenses, including reasonable attorney's fees, arising out
of or related to use of information, services or products offered and/or presented in any electronic
transmittal. In all cases the final stamped plan documents and specifications shall control in the event of a
discrepancy between those documents and the electronic files.
1.11 Regulatory and Legal Compliance Requirements:
No vendor awarded a solicitation will be federally debarred. Such debarment will be checked through the
System for Award Management, at www.sam.gov.
All businesses, organizations, and individuals contracting with Larimer County must comply with Title II of the
Americans with Disabilities Act of 1990, as amended. For more information on these requirements and to read
the full Title II text, please go to the following web page: https://www.ada.gov/ada_title_II.htm.
Domestic Preferences (2 CFR 200.322)
When federal funds are used, Larimer County to the greatest extent practicable and consistent with law, may
provide preference for the purchase, acquisition, or use goods, products, and materials produced in the United
States. This includes, but is not limited to, iron, aluminum, steel, cement, and other manufactured products.
The requirements of 2 CFR 200 must be included in all subawards, contracts, and purchase orders under
Federal awards.
For projects involving infrastructure-whether or not infrastructure is the primary purpose-the stricter of the
Domestic Preference or Buy America requirements will apply (see below).
Buy America Preferences for Infrastructure Projects (2 CFR 184):
When federal funds are used;
* All iron or steel articles, materials, or supplies must be produced entirely in the U.S. (from initial melting
through coatings).
* All manufactured products must be produced in the U.S., with more than 55% of total component costs
coming from U.S. sources.
* All construction materials (non-ferrous metals, plastic and polymer products, glass, fiber optic cable
(including drop cable), optical fiber, lumber, drywall, engineered wood) must be manufactured in the U.S.
* Cement, aggregates (sand, gravel, stone), and aggregate binding agents are excluded and not subject to
Buy America.
Recovered Materials Requirement (2 CFR 200.323):
Larimer County and its contractors must comply with Section 6002 of the Solid Waste Disposal Act (as amended
by the Resource Conservation and Recovery Act). This requires purchasing EPA-designated items (40 CFR Part
247) that contain the highest practicable percentage of recovered materials, consistent with satisfactory
competition. This applies when the item's purchase price exceeds $10,000 or when County purchases of that
item exceeded $10,000 in the previous fiscal year. Covered categories include: paper products, vehicular
products, construction and transportation products, park and recreation products, landscaping products, non-
paper office products, and miscellaneous products.
1.12 Unless otherwise approved by the Engineer, the awarded Contractor shall perform, with its own
organization, not less than 30 percent of the total original contract amount.
1.13 The Contractor certifies that by submitting an offer, neither the contractor nor subcontractors, the
organization nor its principals are suspended or debarred or otherwise excluded from procurement by the
Federal government and do not appear on the Excluded Parties List System (EPLS) maintained by the General
Services Administration (GSA).
B26-04 4 of 6

2. BIDDING INSTRUCTIONS:
2.1 BID DOCUMENTS:
The following items are part of the bid. If any of these items cannot be located, please contact the Purchasing
Agent listed on the first page of the Invitation to Bid (ITB).
* Bid Package
General Instructions
o
Bidding Instructions
o
Bid Form
o
Bid Bond
o
CDOT Form 606 - Anti-Collusion Affidavit
o
Byrd Anti-Lobbying Amendment Certification
o
Certificate of Intent to Sublet
o
* Attachment A - Bid Schedule (in Excel format)
* Attachment B - Sample Contract
Contract Attachment A- Bid Schedule
o
Contract Attachment B - Insurance Requirements
o
Contract Attachment C - Contract Provisions for Non-Federal Entity Contracts under Federal
o
Awards
Contract Attachment D - FHWA 1273 & Wage Decision (CO20260014, Mod 1)
o
Contract Attachment E - Larimer County Title VI Plan (Appendices A and E)
o
Contract Attachment - Payment and Performance Bonds
o
* Attachment C Special Provisions
* Attachment D CDOT Special Provisions (includes Wage Decision CO20260014, Mod 1)
* Attachment E Construction Plans
-CAD Files (containing finished grade and existing ground surface information, as well as existing and
proposed roadway linework provided as a link to a Google Drive-CAD SET
[https://drive.google.com/drive/folders/1JSdWAk1b1qsF7oQGc5HdKkeywkL49lsD?usp=sharing].
* Attachment F Geotechnical Report - Final
* Attachment G Contractor's Acceptance or Rejection of Asphalt Cement Cost Adjustment Form
2.2 BID SUBMITTALS:
Bidders are required to submit one (1) PDF file containing the following documents, in the order listed
below:
1. Bid Form
2. Bid Bond
3. CDOT Form 606 - Anti-Collusion Affidavit
4. Byrd Anti-Lobbying Amendment Certification
5. Certificate of Intent to Sublet
6. Bid Schedule* in PDF format
7. Contractor's Acceptance or Rejection of Fuel Cost Adjustment Form
In addition, bidders are also required to submit the Bid Schedule in Excel format as a separate standalone file.
For the avoidance of doubt, the Bid Schedule must be submitted both:
* Within the PDF file accompanying the other required documents listed above, and
* As an individual Excel file.
* Each bid must contain a 'unit bid price' for each item shown in the Bid Schedule.
*Failure to provide the Bid Schedule in both required formats and in the specified manner may result in
disqualification of your bid.
B26-04 5 of 6

Each Bid must be accompanied by a Bid Guaranty consisting of a Bid Bond in the amount of five percent (5%)
of the contractor's bid, without conditions, payable to Larimer County or your bid will be considered non-
responsive and your bid will be rejected.
The sample Bid Bond included in these bid documents is the only acceptable form for a Bid Bond, no other form
will be accepted. Bid Guaranties may be held until the contract is awarded, provided the time from bid opening to
contract award does not exceed 30 days.
Payment and Performance bonds in the amount of 100 percent of the Award Vendor's Contract price must be
supplied prior to any work beginning.
The signed Anti-Collusion Affidavit must be submitted with your bid, or the bid will be deemed non-
responsive and rejected.
___________________________________________________________________________________________
End of ITB B26-04 Information.
See the referenced bid form, affidavits, & certificates following below and
the additional separate attachments and exhibits linked to this document in BidNet.
B26-04 6 of 6

BID FORM
B26-04, Owl Canyon/CR 70 Road Reconstruction (CR 11 to CR 13)(PN 329)
TO THE BOARD OF COUNTY COMMISSIONERS,
Larimer County, Colorado
I/We have examined the Plans and Specifications and the site of the proposed work and receipt of
Addendum No(s). is hereby acknowledged.
I/We understand and accept the proposition that the Estimate of quantities is approximate only, that the
quantities are subject to either increase or decrease and propose to perform any increased or decreased
quantities of work at the unit price named in this Bid, except for alterations provided for in the Specifications.
I/We agree that the Invitation for Bids, Bid Requirements and Conditions, the Plans and Specifications,
any Special Provisions, and this Bid shall form and be part of the Contract to be signed by me/us if this Bid is
accepted, and that I/we will furnish a Contract Bond in a penal sum equal to the estimated contract price, with
surety, or sureties, to guarantee the completion of the work and also to guarantee that all material and labor
upon this work, or incidental to the completion of this work, shall be fully paid for.
I/We hereby propose to furnish all labor, machinery, equipment, materials and supplies, and to sustain
all the expense incurred in doing the work hereinafter described for what is known as: Bid No. B26-04, Owl
Canyon/CR 70 Road Reconstruction (CR 11 to CR 13)(PN 329), that may be awarded the undersigned in
pursuance of a certain advertisement of the Board of County Commissioners, Larimer County, Colorado, dated
August 17, 2026, a copy of which advertisement is attached and made a part hereof, and in accordance with
the full details, Plans and Specifications as prescribed by said Board of County Commissioners and under the
direction and according to the instructions of said Board or their authorized assistants, for the prices named in
the Bid.
I/We agree to protect my/our employees on this contract, if awarded to ,
by adequate compensation insurance.
I/We agree that any Extra Work or materials which the said Board may order in writing is to be paid for
either at a lump sum or unit prices agreed upon prior to the work on the force account basis as specified in the
Specifications, the force account bills to be checked and signed at the end of each day by the engineer or
inspector in charge, and the Contractor's representative; provided that no class or item of work or material for
which a unit bid price is provided in this Bid is to be classified as Extra Work.
I/We hereby agree to execute a Contract and Bond and supply Insurance Endorsement forms provided
by the said Board within fifteen (15) days (or such further time as may be allowed in writing by the Board) after
receiving notification of the Award of Contract based on this bid, and in case I/we do not, the Board may
proceed to award the contract to another, re-advertise the work for bids, or proceed in any lawful manner they
deem advisable, and the accompanying Guaranty shall become forfeited to Larimer County, Colorado as
liquidated damages.
I/We hereby agree to commence the work within thirty (30) days following the date of award unless
such time for beginning the work is changed by the Engineer in the "Notice to Proceed".
B26-04 BID SIGNATURE FORM 1 of 2

It is agreed that in case the Contract is awarded to another, this Bid Guaranty, unless forfeited as
stated herein, will be returned to:
Respectfully Submitted
Signed Date
Name (Print) Phone No
*Sam.gov
Title
UEI No
Company Name Email
Mailing Address Street Address
County State
Provide the following information for the individual who will serve as primary contact for your
organization for technical and contractual management. This should be the same person that will be listed in
Section 7 (page 4) of the contract:
Name Title
Mailing Address Street Address
Phone No Email
Bid must be signed by the bidder with the signature in full. Anyone signing the Bid must have
authority to do so.
Each Bid must contain a unit bid price for each item shown in the bidding schedule, a completed
Certificate of Intent to Sublet, a signed affidavit relative to collusion and a completed Bid Bond in the amount
of Five Percent of the Contractor's total bid. The bid bond will be in the format presented in the bid. No
other wording will be accepted. Failure to include unit bid prices, said certificate, signed affidavit and bid
bond may be cause for rejection.
*Unique Entity ID number (from SAM.gov federal Excluded Parties List System)
B26-04 BID SIGNATURE FORM 2 of 2

BID BOND
Any singular reference to Bidder , Surety, Owner, or other party shall be considered plural where applicable.
BIDDER
(Name and Address):
SURETY
(Name and Address of
Principal Place of Business):
OWNER
Larimer County, 200 West Oak Street, Suite 3000, Fort Collins CO 80521
(Name and Address):
BID
Bid Due Date & Time
Bid Description Bid No. B26-04, Owl Canyon/CR 70 Road Reconstruction (CR 11 to CR 13)(PN
(Proposal Name & Number): 329)
BOND
Bond Number:
Date:
Penal Sum (Words):
Penal Sum (Figures): $
Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth below, do each cause this
Bid Bond to be duly executed by an authorized officer, agent or representative. Said Bidder and Surety each
separately, severally and jointly hereby bind themselves, their heirs, executors, administrators, successors and
assigns firmly by these presents.
The conditions of this bond are such that whereas said Bidder is about to submit a bid to Owner to furnish all
services, labor, materials and equipment necessary for the improvement of a project known as Bid No. B26-04,
Owl Canyon/CR 70 Road Reconstruction (CR 11 to CR 13)(PN 329).
NOW THEREFORE, if the above bound Bidder is awarded the contract for the Work upon which s/he bid, s/he
shall, within fifteen (15) days of such award, enter into a written contract with Owner in the form set out in the
Contract Documents for said Work and shall furnish bond executed by an acceptable surety company. Upon
meeting the foregoing requirements this Bid Bond shall be null and void, otherwise, it shall remain in full force
and effect.
BIDDER SURETY
____________________________________ (SEAL) _____________________________________(SEAL)
Bidder's Name and Corporate Seal Surety's Name and Corporate Seal
By_________________________________________ By_________________________________________
Signature Signature
Print Name Print Name
Attest:______________________________________ Attest:______________________________________
Signature Signature
Title:_______________________________________ Title:_______________________________________
B26-04 BID BOND FORM 1 of 1

Colorado Department of Transportation Anti Collusion Affidavit - Form 606
Instructions: Form to be completed by an authorized agent or Officer for the bidder/Contractor submitting a bid for
the Colorado Department of Transportation Project identified below.
Project Number:
I hereby attest that I am the person responsible within my firm for the final decision as to the price(s) and amount of
this bid or, if not, that I have written authorization, enclosed herewith, from that person to make the statements set
out below on their behalf and on behalf of my firm. I further attest that:
1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication,
or agreement for the purpose or with the effect of restricting competition with any other firm or person who is a
bidder or potential prime bidder.
2. Neither the price(s) nor the amount of this bid have been disclosed to any other firm or person who is a bidder
or potential prime bidder on this project and will not be so disclosed prior to bid opening.
3. Neither the prices nor the amount of the bid of any other firm or person who is a bidder or potential prime bidder
on this project have been disclosed to me or my firm.
4. No attempt has been made to solicit, cause, or induce any firm or person who is a bidder or potential prime
bidder to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any
intentionally high or noncompetitive bid or other form of complementary bid.
5. No agreement has been promised or solicited for any other firm or person who is a bidder or potential prime
bidder on this project to submit an intentionally high, noncompetitive, or other form of complementary bid on
this project.
6. The bid of my firm is made in good faith and not pursuant to any consultation, communication, agreement or
discussion with, or inducement or solicitation by or from any firm or person to submit any intentionally high,
noncompetitive, or other form of complementary bid.
7. My firm has not offered or entered into a subcontract or agreement regarding the purchase or sale of materials
or services from any firm or person, or offered, promised or paid cash or anything of value to any firm or
person, whether in connection with this or any other project, in consideration for an agreement or promise by
any firm or person to refrain from bidding or to submit any intentionally high, noncompetitive or other form of
complementary bid or agreeing or promising to do so on this project.
8. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or
services to any firm or person and has not been promised or paid cash or anything of value by any firm or
person, whether in connection with this or any other project, in consideration for my firm's submitting any
intentionally high, noncompetitive, or other form of complementary bid, or agreeing or promising to do so, on
this project.
9. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities
relating to the preparation, approval or submission of my firm's bid on this project and have been advised by
each of them that he or she has not participated in any communication, consultation, discussion, agreement,
collusion, or other conduct inconsistent with any of the statements and representations made in this affidavit.
10.I understand and my firm understands that any misstatement in this affidavit is and shall be treated as a
fraudulent concealment from the Colorado Department of Transportation, of the true facts relating to submission
of bids for this contract.
Signature Declaration: I declare under penalty of perjury in the second degree, and any other applicable state or
federal laws, that the statements made on this document are true and complete to the best of my knowledge.
B26-04 CDOT AC AFFIDAVIT Form Number 606 - April 2024 1 of 1