Form_9.2_-_Respondent's_Acknowledgement_Form.pdf

FORM 9.2 – RESPONDENT’S ACKNOWLEDGEMENT FORM

I have carefully examined the Request for Proposal (RFP), Instructions to Respondents, General and/or Special Conditions, Specifications and any other documents accompanying or made a part of this request.

I hereby propose to furnish the goods or services specified in the RFP at the prices or rates as finally negotiated. I agree that my proposal will remain firm for a period of up to one-hundred-twenty (120) days in order to allow the City of Port Orange adequate time to evaluate the proposal. Furthermore, I agree to abide by all conditions of the RFP.

I certify that all information contained in the proposal is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to submit this proposal on behalf of the Respondent/Contractor as its act and deed and that the Respondent/Contractor is ready, willing and able to perform if awarded a contract.

I further certify that this proposal is made without prior understanding, contract, connection, discussion or collusion with any person, firm or corporation submitting a proposal for the same product or service; no officer, employee or agent of the City of Port orange City Council or of any other Respondent interested in said RFP; and that the undersigned executed this Respondent’s Acknowledgement with full knowledge and understanding of the matters therein contained and was duly authorized to do so.

I further certify that having read and examined the specifications and documents for the designated services and understanding the general conditions for the contract under which services will be performed, do hereby propose to furnish all labor, equipment and material to provide the services set forth in the RFP.

I hereby declare that the following listing states any clarifications, any and all variations from and exceptions to the requirements of the specifications and documents. The undersigned further declares that the “work” will be performed in strict accordance with such requirements and understands that any exceptions to the requirements of the specifications and documents may render the proposal non-responsive.

NO EXCEPTIONS ALLOWED AFTER THE PROPOSAL IS SUBMITTED:

Please check one: ☐I take NO exceptions. ☐Exceptions (list below; add additional pages if necessary):

Name of Business Mailing Address

Authorized Signature City, State & Zip Code

Printed Name and Title Telephone Number

Federal Identification No. E-mail Address

STATE OF:_________________________ COUNTY OF: _______________________

The foregoing instrument was acknowledged before me by means of ☐physical presence or ☐online notarization, this

_________ day of _______________________, 2025, by____________________________________________________________ and who:

☐Is personally known to me; or ☐ has produced __________________ as identification.

________________________________________________________________ Notary Public, State of ______________________________________ Printed, typed or stamped name, commission and expiration:

This document must be completed and returned with your submittal