Project No.:	enter text	Project ID:	enter text
Description	enter text	Parcel No.:	enter text

Owner Name:	enter text
Address:	enter text

The Montana Department of Transportation requests that you furnish a replacement cost new estimate, for the items listed below. The estimate is to include the architect fee or engineering fee, if any, contractor's profit, and other contingencies. Estimates should indicate specific items and typical labor, and the estimate should reflect a value that would be good for not less than 180 days from the date provided.

It is understood that the estimate shown would be similar to those in a competitive situation had you been given the opportunity to bid with others for the job. This estimate is to be used for appraisal purposes only, and there is no implication that this request constitutes a binding bid on the estimator. Every effort should be made to provide a bid as if the provider was going to actually do the work as if this were a binding bid. Any limitations placed on the estimate by the provider should be set forth under "Comments".

ITEMS (Description Specified by State)	Contractor's Segregated Est.	Sub Total
TOTAL REPLACEMENT COST NEW FOR ALL ITEMS:

NAME OF COMPANY (PRINT OR TYPE):	enter text
NAME OF ESTIMATOR (PRINT OR TYPE):	enter text
SIGNATURE/INITIAL OF ESTIMATOR:	enter text
DATE:	choose a date
APPRAISAL SECTION APPROVAL: enter text	DATE: choose a date
COMMENTS: enter text