IWQ 1-XXXXXX
Page 1
DATE:
QUOTE NUMBER:
QUOTES SHOULD BE RECEIVED BY:
January 20, 2026
IWQ 121396
January 27, 2026 at 3:00 PM
Informal Written Quotations are being solicited from qualified suppliers for the following item(s). Informal Written Quotations may be returned via: Email:
Jordan.Mitchell@GwinnettCounty.com ; or Gwinnett County Department of Financial Services, Purchasing Division, 75 Langley Drive, Lawrenceville, Georgia, 30046, Attn: Jordan
Mitchell. Questions regarding quotes should be directed to Jordan Mitchell, Purchasing Associate II, at Jordan.Mitchell@GwinnettCounty.com or by calling 770-822-5491.
DELIVERY FOB DESTINATION PRE-PAID AND ALLOWED TO: Gwinnett County Department of Water Resources – 2590 South Waterworks Road, Buford. GA 30518
QTY
DESCRIPTION
MFG & NO.
DELIVERY A.R.O.
1 EA
Lump sum cost for 16” check valve designed
to prevent backflow in potable piping systems
NOTES:
• Unit Price must include ALL charges, including but not limited to supply and delivery.
• If you are quoting an equivalent to the specified items, please send specifications with your submittal.
TOTAL PRICE
$
Certification of Non-Collusion in Quote Preparation
Signature
Date
In compliance with the attached specifications, the undersigned offers and agrees, within ninety (90) days of the date of quote opening, to furnish any or all of the items upon which
prices are quoted, at the price set opposite each item, delivered to the designated point(s) within the time specified in the quote schedule. By submission of this quote, I understand
that Gwinnett County uses Electronic Payments for remittance of goods and services. Vendors should select their preferred method of electronic payment upon notice of award. For
more information on electronic payments, please refer to the Electronic Payment information in the instructions to vendors.
Legal Business Name
Federal Tax ID
Complete Address
Does your company currently have a location within Gwinnett County? Yes No
Representative Signature
Printed Name
Telephone Number
Fax Number
E-mail Address
IWQ 121396
16-Inch Check Valve – Specification Data Sheet
Page 2 of 16
1. General Description The 16-inch check valve is designed to prevent backflow in potable piping
systems. The valve operates automatically to allow flow in one direction and closes upon reverse flow,
protecting the system from water hammer. Suitable for horizontal or vertical installation (flow upward).
Valve Type: Swing Check Valve with a bottom buffer with adjustable final closing speed control.
Nominal Size: 16 inches (DN 400) Valve Lay Length of 39 ¼ inches
Pressure Rating: ANSI Class 150 (150 psi / 10 bar)
2. Standards Compliance
Standard
Description
AWWA C508 / C515 Ductile iron check valve for water service
MSS SP-70
Gray and ductile iron check valves
ASME B16.1
Flanged dimensions
NSF/ANSI 61
Potable water approval
3. Performance Data
Parameter
Value
Maximum Working Pressure 150 psi (10 bar)
Hydrostatic Test Pressure 225 psi (15.5 bar)
End-to-End Pressure Drop ≤ 5 psi at rated flow
Temperature Range
33°F – 140°F (0.5°C – 60°C)
Flow Orientation
Horizontal or vertical (upward flow)
4. Materials of Construction
Component
Body
Bonnet
Disc / Wheel
Seat
Material
Cast Iron, ASTM A126 Class B
Ductile Iron ASTM A536
Stainless Steel ASTM A356 Grade 65-45-12 Ductile Iron
Lead Free Bronze C95400 (potable water compatible)
IWQ 121396
Component
Material
Hinge Pin / Shaft
Stainless Steel ASTM A276 Type 316
Fasteners (Bolts / Nuts) Stainless Steel ASTM A193 / A194
Gasket
EPDM / NBR
5. End Connections – Standard: ANSI Class 125 flanged, drilled per ASME B16.1
Page 3 of 16
6. Operation & Maintenance - Automatic, flow-actuated, no external power required - Designed to
minimize water hammer - Internal inspection and seat/disc replacement without removing valve body -
Lubrication-free operation
Notes: - Suitable for potable water, raw water, and wastewater applications - All materials comply with
project water quality standards.
IWQ 121396
Page 4 of 16
IWQ 121396, Purchase of Tilting Disc Check Valve
CONTRACTOR AFFIDAVIT AND AGREEMENT
(THIS FORM SHOULD BE FULLY COMPLETED AND RETURNED WITH YOUR SUBMITTAL)
By executing this affidavit, the undersigned contractor verifies its compliance with The Illegal Immigration Reform
Enhancements for 2013, stating affirmatively that the individual, firm, or corporation which is contracting with the Gwinnett
County Board of Commissioners has registered with and is participating in a federal work authorization program* [any of the
electronic verification of work authorization programs operated by the United States Department of Homeland Security or any
equivalent federal work authorization program operated by the United States Department of Homeland Security] to verify
information of newly hired employees, pursuant to the Immigration Reform and Control Act, in accordance with the applicability
provisions and deadlines established therein.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the
physical performance of services or the performance of labor pursuant to this contract with the Gwinnett County Board of
Commissioners, contractor will secure from such subcontractor(s) similar verification of compliance with the Illegal Immigration
Reform and Enforcement Act on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form.
Contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the Gwinnett
County Board of Commissioners at the time the subcontractor(s) is retained to perform such service.
_________________________________________
E-Verify * User Identification Number
_____________________________________
Date Registered
_________________________________________
Legal Company Name
_________________________________________
Street Address
_________________________________________
City/State/Zip Code
_____________________________________
BY: Authorized Officer or Agent
(Contractor Signature)
_____________________________________
Date
__________________________________________
Title of Authorized Officer or Agent of Contractor
For Gwinnett County Use Only:
Document ID #________________
___________________________________________
Printed Name of Authorized Officer or Agent
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
_______ DAY OF ______________________, 20_______
Issue Date: ___________________
Initials: ______________________
________________________________________________
Notary Public
My Commission Expires: ___________________________
* As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is “E-Verify” operated by the U.S. Citizenship and
Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).
IWQ 121396
REFERENCES
Page 5 of 16
Gwinnett County requests a minimum of three (3) references where work of a similar size and scope has been
completed.
Note: References should be customized for each project, rather than submitting the same set of references for
every project bid. The references listed should be of similar size and scope of the project being bid on. Do not
submit a project list in lieu of this form.
1. Company Name
Brief Description of Project
Completion Date
Contract Amount $
Start Date
Contact Person
Telephone
E-Mail Address
2. Company Name
Brief Description of Project
Completion Date
Contract Amount $
Contact Person
E-Mail Address
Start Date
Telephone
3. Company Name
Brief Description of Project
Completion Date
Contract Amount $
Contact Person
E-Mail Address
Start Date
Telephone
Company Name
This is the opportunity summary page. It provides an overview of this opportunity and a preview of the attached documentation.