Attachment_A_-_Proposer_form.doc

Attachment A Proposer’s Information Form

PROPOSER (please type/ print):

Name:

Address:

Telephone:

_______________________ Email: ______________________________

Contact Person: _______________________________________Title: _______________ eMail (Required): ________________________________________________________

Telephone (Required): ________________________________ Proposer, if selected, intends to carry on the business as (check one):

Individual

Joint Venture

Partnership

Corporation

When incorporated?

In what state?

When authorized to do business in California?

Other (explain):____________________________________________________

ADDENDA

To assure that all Proposers have received each addendum, check the appropriate box(s) below. Failure to acknowledge receipt of an addendum/addenda may be considered an irregularity in the Proposal:

Addendum number(s) received:

FORMCHECKBOX

1;

FORMCHECKBOX

2;

FORMCHECKBOX

3;

FORMCHECKBOX

4;

FORMCHECKBOX

5;

FORMCHECKBOX

6;

Or, FORMCHECKBOX

_____ _____No Addendum/Addenda Were Received (check and initial).

PROPOSER’S SIGNATURE

No proposal shall be accepted which has not been signed in ink in the appropriate space below:

Attachment A – Proposer Information continued…

1. If Proposer is INDIVIDUAL, sign here

Date: ________________________ __________________________________________

Signature

Name and Title (type or print)

2. If Proposer is PARTNERSHIP or JOINT VENTURE; at least two (2) Partners shall sign here:

Partnership or Joint Venture Name (type or print)

Date:______________

Member of the Partnership or Joint Venture signature

Date:______________

Member of the Partnership or Joint Venture signature

3. If Proposer is a CORPORATION or LLC, the duly authorized officer(s) shall sign as follows:

The undersigned certify that he/she is respectively:

Officer Signature

Name

Title

Corp./LLC Contract Signature Method: Authorization to sign contracts and other documents on behalf of the corporation must be indicated by selecting one of the following methods:

· Method 1 (Two Specified Officers). Authorization may be shown by two officers, one from each of the following groups, signing the instrument. (Corp. Code §§313; 5214.)

(i) Chairman of the Board

(ii) President

(iii) Any Vice-President Email:_______________________________

(i) Secretary or Assistant Secretary

(ii) Chief Financial Officer

(iii) Any Assistant Treasurer Email:________________________________

· Method 2 (Certified Board Authorization). Authorization may be shown by providing the City a copy of the corporation’s bylaws, board of directors meeting minutes, or any resolution of corporation’s board authorizing the person signing the instrument to execute instruments of the type in question, and certified by the Secretary or Asst. Secretary of the corporation to be a true copy. (Corp. Code §§314; 5215.)

· Method 3 (Notarized Officer Signature). Authorization may be shown by the signature of either the corporation’s president, vice president, secretary, or assistant secretary accompanied by a notary acknowledgment in the form prescribed by Civil Code §1189. (Civil Code §1190.)

Of the corporation named below; that they are designated to sign the Proposal Cost Form by resolution (attach a certified copy, with corporate seal, if applicable, notarized as to its authenticity or Secretary’s certificate of authorization) for and on behalf of the below named CORPORATION, and that they are authorized to execute same for and on behalf of said CORPORATION.

Corporation Name (type or print)

By:______________________________________ Date: _________________

Title:__________________________________________

By signing below, the submission of a proposal shall be deemed a representation and certification by the Proposer that they have investigated all aspects of the RFP, that they are aware of the applicable facts pertaining to the RFP process, its procedures and requirements, and they have read and understand the RFP. No request for modification of the proposal shall be considered after its submission on the grounds that the Proposer was not fully informed as to any fact or condition.

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City of Palo Alto