Consultant_Listing_and_Proposer_Certification.pdf

PDF 197 KB Posted

Attached to
San Rafael Bridge Seismic Retrofit (BHLS-5064(101))
Solicitation number
2024-RFP-0637
Issued by
Los Angeles County, California

About this file

This document contains a Consultant Listing form and a Proposer Certification for a project involving the San Rafael Bridge Seismic Retrofit. The form provides a template for listing consultants, their small or micro-business status, and their percentage of project scope. The certification page requires the proposer to verify the accuracy of all representations made in the proposal under penalty of perjury, with space to acknowledge receipt of potential addenda to the project documentation.

The document appears to be part of a proposal submission for environmental document preparation and PS&E (Plans, Specifications, and Estimates) for a bridge seismic retrofit project. The form allows for multiple consultants to be listed, with provisions for certifying their business size and project involvement. The certification requires a signature from an authorized representative, who must attest to the truthfulness of the submitted information, though specific financial details or exact project scope are not provided in these pages.

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Text version

CONSULTANT LISTING

Consultant Small or Micro- Business

(Attach Certification)

Yes/No

Percent of Project Scope of Work

(Do Not Enter Dollar Value)

I, the undersigned, hereby certify under penalty of perjury that all representations made in this Proposal for preparation of environmental document and PS&E for the San Rafael Bridge Seismic Retrofit are true and correct to the best of my knowledge at the time of the Proposal’s submission.

Addenda Received:

Addendum No. , dated , 2024

Signature of party legally authorized to sign for Proposer

Print Name and Title

Date

TEskandary Text Box

PROPOSER CERTIFICATION

File details come from the government source that posted it. Updated .