Public Bid Kiosks July 2026.docx

WESTERN REGIONAL

OFF-TRACK BETTING

CORPORATION

Public Bid Date: July 31, 2026 Time: 10:00 a.m.

CASH KIOSK

Western Regional Off-Track Betting Corporation 8315 Park Road Batavia, New York 14020 585-343-1423

INVITATION FOR BIDS

The Western Regional Off-Track Betting Corporation, whose corporate offices are located at 8315 Park Road, Batavia, NY 14020, hereby invites the submission of sealed bids for cash kiosks.

Specifications and bid forms may be obtained from the office of Megan M. Glor, Director of Purchasing/Procurement Officer, upon request by calling (585) 343-1423 or via email at mglor@westernotb.com.

Sealed bids will be publicly opened and read in the Robert J. Kane boardroom at said corporate offices, located within Batavia Downs Gaming & Hotel, at 10:00 a.m. on Friday, July 31, 2026

All bids must be accompanied by the following documents: non-collusion certification, Finance Law Affirmation of Understanding §139-j and Certification of Compliance §139-k (3).

INSTRUCTIONS FOR BIDDERS

1.1 Purpose

The Western Regional Off-Track Betting Corporation (WROTB) hereby invites the submission of sealed bids from qualified companies for the purchase of two (2) cash kiosks as specified within these specifications.

Prospective bidders must offer a proposal that will meet the scope of the products required within the document specifications.

1.2 Procurement Officer

The Procurement Officer identified below is the sole point of contact regarding this bid from the date of issuance until the selection of the successful bidder.

1.3 Presentation and Clarification of WROTB’s Rights and Intentions

WROTB is not committed to award a contract or assignment to any responding bidder, or to pay any costs incurred in the preparation of the proposal in response to this request, or to procure or contract for any services. WROTB reserves the right, in its sole discretion, to (a) accept or reject in part or in its entirety any proposal received as a result of this bid if it is in the best interest of WROTB to do so.

The Western Regional Off-Track Betting Corporation will accept sealed bids for two (2) cash kiosks. WROTB has concluded that a single proposer shall be selected based on the total bid cost. As such, you are being invited to submit your bid to the attention of Megan M. Glor, Director of Purchasing/Procurement Officer via sealed envelope and is to be received no later than 10:00 a.m. EST on Friday, July 31, 2026.

Each bid shall be submitted in a sealed envelope clearly marked as to the contents therein, bearing on the outside the name and address of the vendor. Bids must be mailed or delivered to the aforementioned address so as to be received prior to the time set forth in the advertisement for opening bids.

Faxed or emailed bids will not be accepted. Bidders are responsible for the timely delivery of bid packages to WROTB at the date and time specified therein.

Proponent must not have been an Officer, Board of Director or employee of WROTBC within the last (3) three years.

Bidders shall read thoroughly and understand the specifications, bid conditions, and contract content contained herein.

1.4 Overview of the Organization

The Western Regional Off-Track Betting Corporation (WROTB) is one of five (5) Regional OTB Corporations established and financed by their respective municipal sponsors following the enactment of permissive legislation by New York State in 1973. WROTB is established as a public benefit corporation. Its geographical area is comprised of seventeen (17) counties, fifteen (15) of which participate as members of WROTB, and the two (2) cities of Rochester and Buffalo. The statutory objective of WROTB is:

WROTB began its pari-mutuel wagering operations in May of 1974 with twenty-nine (29) branch facilities and a telephone betting operation opened by 1974’s year end. Today, WROTB is a multi-faceted gaming enterprise which operates the following:

· Six (6) traditional brick and mortar off-track betting facilities.

· One (1) “enhanced” branch facilities defined as having food concession services on-site.

· Twenty-three (23) EZ Bet locations.

· One internet wagering site referred to as “Batavia Bets”.

· One telephone betting center referred to as “Dial-A- Bet” located at Batavia Downs Gaming.

· One inter-track wagering (ITW) facility located at Batavia Downs Gaming.

· Operation of a seventy-one (71) day live harness racing meet conducted at Batavia Downs Gaming.

· Operation of a video lottery gaming facility located at Batavia Downs Gaming with 946 gaming machines.

· Operation of food and beverage venues located at Batavia Downs Gaming.

Diversity, Equity, and Inclusion are very important to WROTB. Proponent/bidder/firm must demonstrate a similar commitment in its response to this contract.

1.5 Specifications – Cash Kiosks

Bidders must be licensed with the New York State Lottery and be compatible with the MGAM System Units must be compatible with New York Video Lottery Terminal Central Server – Everi, Inc.

· Unit to function as an ATM, bill breaker and ticket redemption.

· LCD J Curved Monitor - 30” – 49” screen size

· 6 High Dispenser

· Encrypted Pin Pad, PCI Certified 5.0

· Bill validators

· MEI BV Bezels

· Sanyo ATM card reader

· Paycheck4 TITO Printer

· PC Hard Drive

· Twelve (12) Spare cassette

· S4 note configuration – 1s, 5s, 20s, 100s

· Each cassette to hold 2,500 notes and 2 are required.

· Dispense dollar bills – 4 denominations

Public Bid – Cash Kiosks

1.7 Submission of Bidder’s Statement of Proposal

To be considered, bidders must submit a complete response to this bid package. Bidders not responding to all information requested in this or indicating exceptions to those items not responded to may have their bid rejected.

Sealed bids will be received at the address below on or before 10:00 a.m. EST on Friday, July 31, 2026, which at that time bids will be publicly opened and read.

Attention:

Director of Purchasing/Procurement Officer

All bids must be accompanied by a non-collusion bidding certification, references page, Finance Law Affirmation of Understanding §139-j and Certification of Compliance §139-k (3) in order to be considered.

1.8 Clarification of Specifications

Questions that arise from the date of the bid being in advertisement to the date the award is made must be submitted in writing to the Procurement Officer listed on page 1 of this bid package. Questions and answers will be provided via addendum to all potential respondents who have received bid packages and must be acknowledged in the proposed response. No contact will be allowed between the respondent and any other employee of WROTB regarding this bid during this restrictive period. Prohibited contact will be grounds for respondent disqualification.

1.9 Addenda

In the event it becomes necessary to revise any part of the specifications, an addendum will be provided to all that received the bid package. An acknowledgement of such addenda, if any, must be submitted with bidder’s response.

2.0 Sales Tax

The Western Regional Off-Track Betting Corporation is exempt from paying any State and Local sales tax. Vendors shall not include any such taxes in their bids.

2.1 Prevailing Rates of Wage

The successful bidder will be required to pay each laborer, workman or mechanic employed by the contractor or sub-contractor not less than the New York State Department of Labor prevailing rates of wages, which are included in this bid package. The successful bidder, as required by section 220 of the New York State Labor Law (paragraph 3-a) which was amended on March 13, 1997:

“………shall submit to the department of jurisdiction within thirty days after issuance of its first payroll, and every thirty days thereafter, a transcript of the original payroll record…….subscribed and affirmed as true……..”

2.2 Investigations

WROTB reserves the right to conduct any investigations necessary to verify information submitted by the respondent and/or to determine the respondent’s capability to fulfill the terms and conditions of the scope of services that is described herein. WROTB reserves the right to visit a prospective respondent’s place of business to determine the existence of the company and the management capabilities required to administer this contract. WROTB will not consider respondents that are in arrears to WROTB, in bankruptcy, or in the hands of a receiver at the time of responding or at any time of selection.

2.3 Reservation of Rights

WROTB reserves the right to refuse any and all responses, in part, or in their entirety, or select certain aspects from various respondents, or to waive any informality or defect in any response should it be deemed in the best interest of WROTB. WROTB is not committed, by virtue of this bid, to make an award of the bid. The proposals submitted become the property of WROTB.

2.4 Material Submitted

All rights, title and interest in the material submitted by the bidder shall vest in WROTB upon submission of the response to WROTB without any obligation or liability by WROTB to the respondent. WROTB has the right to use all ideas presented by a responder.

2.5 Procurement Policy

Pursuant to State Finance Law §139-j and §139-k, this bid includes and imposes certain restrictions on communications between a Government Entity (WROTB) and a Bidder during the procurement process. Bidder is restricted from making contacts from the earliest notice of intent to solicit offers through the final award and approval of the Procurement Contract by WROTB. (“Restricted Period”), to other than WROTB’s Procurement Officer unless it is a contact that is included among certain statutory exceptions set forth in State Finance Law Section §139-j. WROTB’s Procurement Officer for this Government Procurement, as of the date thereof, is identified on the first page of this bid document. WROTB employees are also required to obtain certain information when contacted during the Restricted Period and make a determination of the responsibility of the Bidder pursuant to the two statutes. Certain findings of non-responsibility can result in rejection for contract award and in the event of two findings within a four (4) year period, the Bidder is debarred from obtaining Procurement Contracts. Further information about these requirements may be obtained from the Procurement Officer.

WROTB reserves the right to terminate this contract in the event it is found the certification filed by the Bidder in accordance with State Finance Law §139-k (3) was intentionally false or intentionally incomplete. Upon such finding, WROTB may exercise its termination right by providing written notification to the Bidder in accordance with the written notice terms of this contract. WROTB reserves the right to reject any and all bids if deemed it to be in the best interest of the Corporation and to waive any informalities thereof.

Bidder cannot currently , nor within the last five (5) years , be suspended , debarred, or similarly declared ineligible from state or federal contracting. The bidder also certifies upon submission of this bid/proposal that it is not currently under investigation by any state, local or federal agency or authority.

2.6 Site Visits

Bidders are encouraged to visit and inspect the site prior to submitting their bid. Contact to do so shall be corresponded with the Procurement Officer assigned to this bid proposal, listed on Page 1 of these specifications.

2.7 Contractor’s Responsibility

These specifications shall not be construed as placing the work under the specific direction or control of WROTB or relieving the contractor from liability as an independent, as such, the contractor shall be solely responsible for the method, manner and means by which the work shall be performed, including, but not limited to supervision and control of their employed personnel and scheduling of the work required to insure proper and timely performance and shall exercise due care to prevent bodily injury and damage to property in the prosecution of the work required.

2.8 Prosecution of Work

The contractor shall give their personal attention to the work while in progress and shall provide a competent and reliable Supervisor at all times. Any discrepancies or questions pertaining to the extent of the work once the award is made shall be submitted immediately to the Director of Purchasing and Real Estate. If the Contractor fails to begin the work within the time specified, fails to perform the work with adequacy, or performs the work unsuitable and not carry the work in an acceptable manner, the Owner shall give notice in writing to Contractor and Owner shall have full power and authority without violating contract to take over the completion of the work.

2.8 Payment

The successful bidder shall furnish to WROTB a complete itemized invoice, including prevailing rate of wage and certified copy of payroll. Payment shall be made within thirty (30) days after the completion and acceptance of the work.

FAILURE TO SUBMIT ANY OF THESE ITEMS WITH BID IS MANDATORY CAUSE FOR REJECTION

Document Required Bidders Initials

Bid Proposal

Acknowledgement of receipt of addenda

Non-Collusion Bidding Certification

References

Offerer’s Certification of Compliance

Offerer Disclosure of Prior Non-Responsibility

Offerer’s Affirmation of Understanding/Agreement

THE UNDERSIGNED BIDDER HEREWITH SUBMITS THE ABOVE REQUIRED DOCUMENTS.

PRINT OFFICIAL COMPANY NAME:

SIGNED BY:

PRINT NAME AND TITLE:

DATE:

THIS CHECKLIST IS REQUIRED TO BE INITIALED AND SIGNED WHERE INDICATED

AND RETURNED WITH ALL DOCUMENTS

REFERENCES - Bidders must supply a minimum of three (3) references based on projects of a similar nature.

COMPANY/FIRM _________________________

CONTACT NAME

COMPANY/FIRM _________________________

CONTACT NAME

COMPANY/FIRM _________________________

CONTACT NAME

BIDDERS MUST SIGN BELOW AND RETURN THIS SHEET WITH THEIR BID DOCUMENTS

SIGNATURE COMPANY NAME

PRINTED NAME OF PERSON ABOVE ADDRESS

TITLE CITY, STATE & ZIP CODE

DATE TELEPHONE NUMBER

NON-COLLUSION BIDDING CERTIFICATION

By submission of this bid, the authorized representative signing on behalf of any bidder certifies and in the case of a joint bid, each party thereto certifies as to its own organization, under penalty of perjury, that to the best of the representative’s knowledge and belief:

In compliance with this invitation for bids and subject to the conditions thereof, the undersigned offers and agrees, if this bid is accepted within forty-five (45) days from the date of the opening, to furnish any and all items upon which prices are submitted.

AUTHORIZED REPRESENTATIVE BUSINESS NAME

PRINT NAME ADDRESS

TITLE CITY, STATE & ZIP CODE

DATE TELEPHONE #

EMPLOYER TAX ID FAX NUMBER

OR SOCIAL SECURITY #

YOU MUST SIGN AND RETURN THIS SHEET WITH YOUR BID

YOU MUST SIGN AND RETURN THIS SHEET WITH YOUR PROPOSAL

Offerer's Certification of Compliance with State Finance Law § 139-k(S)

New York State Finance Law §139·k(5) requires that every Procurement Contract award subject to provisions of State Finance Law §139-k or §139-j shall contain a certification by the Offerer that all information provided to the Office of General Services with respec.t to State Finance law §139-k is complete, true, and accurate.

Offerer Certification:

I certify that all information provided to the Western Regional Off-Track Betting Corporation with respect to State Finance Law §139-k is complete, true, and accurate.

By: Date: _

Name:

Title:

Procurement Lobbying Termination

Western Regional Off-Track Betting Corporation reserves the right to terminate this contract in the event it is found that the certification filed by the Offerer in accordance with New York State Finance Law §139-k was intentionally false or intentionally incomplete. Upon such finding, Western Regional Off-Track Betting Corporation may exercise its termination right by providing written notification to the Offerer in accordance with the written notification terms of this contract.

Offerer Disclosure of Prior Non-Responsibility Determinations See instructions on next page before completing this form.

Name of Individual or Entity Seeking to Enter into the Procurement Contract:

Address:

No If yes, please answer the next questions:

Yes

2. Was the basis for the finding of non-responsibility due to a violation of State Finance Law §139-j (Please circle):

No Yes

3. Was the basis for the finding of non-responsibility due to the intentional provision of false or incomplete information to a Governmental Entity? (Please circle):

No Yes

4. If you answered yes to any of the above questions, please provide details regarding the finding of non-responsibility below and attach additional pages as necessary.

Governmental Entity:

Date of Finding of Non-responsibility:

Basis of Finding of Non-Responsibility:

5. Has any Governmental Entity or other governmental agency terminated or withheld a Procurement Contract with the above-named individual or entity due to the intentional provision of false or incomplete information? (Please circle):

No Yes

6. If yes, please provide details below and attach additional pages as necessary.

Governmental Entity: Date of Termination or Withholding of Contract _ Basis of Termination or Withholding:

Offerer certifies that all information provided to the Governmental Entity with respect to State Finance Law §139-k is complete, true, and accurate.

By: Date:

Signature

Instructions Offerer Disclosure of Prior Non-Responsibility Determinations Background:

New York State Finance Law §139-k (5) obligates a Government Entity to obtain specific information regarding prior non-responsibility determinations with respect to State Finance Law 139-j. In accordance with State Finance Law 139-k, an Offerer must be asked to disclose whether there has been a finding of non-responsibility made within the previous four (4) years by any Governmental Entity due to: (a) a violation of State Finance Law §139·j or (b) the intentional provision of false or incomplete information to a Governmental Entity. The terms "Offerer" and "Governmental Entity” are defined in State finance Law§ 139-k. State Finance Law §139-j sets forth detailed requirements about the restrictions on Contacts during the procurement process. A violation of State Finance Law §139-j includes, but is not limited to, an impermissible Contact during the restricted period (for example, contacting a person or entity other than the designated contact person, when such contact does not fall within one of the exemptions).

As part of its responsibility determination, State Finance Law §139-k(5) mandates consideration of whether an Offerer fails to timely disclose accurate or complete information regarding the above non-responsibility determination. In accordance with law, no Procurement Contract shall be awarded to any Offerer that fails to timely disclose accurate or complete information under this section, unless a finding is made that the award of the Procurement Contract to the Offerer is necessary to protect public property or public health safety, and that the Offerer is the only source capable of supplying the required Article of Procurement within the necessary timeframe. See State Finance Law §§139-j (3) and §139-k (5).

Instructions:

The Western Regional Off-Track Betting Corporation includes this disclosure request regarding prior non-responsibility determinations in accordance with State Finance Law §139-k in its solicitation of proposals or bid documents or specifications or contract documents, as applicable, for procurement contracts. The attached form is to be completed and submitted by the individual or entity seeking to enter into a Procurement Contract, Supplement or Change Order.

This document must accompany each Bid Form, Letter of Interest, or Proposal submitted by an offerer and will be required for any contract amendments over $15,000. This document must also accompany each Emergency Contract Bid Form.

Offerer’s Affirmation of Understanding of and Agreement pursuant to New York State Finance Law §139-j (3) and §139-j (6) (b)

New York State Finance Law §139-j (6) (b) provides that:

Every Government Entity shall seek written affirmations from all Offerers as to the Offerer’s understanding of and agreement to comply with the Government Entity’s procedures relating to permissible contacts during a Governmental Procurement pursuant to subdivision three of this section.

Offerer affirms that it understands and agrees to comply with the procedures of the Government Entity relative to permissible contacts as required by New York State Finance Law §139-j (3) and §139-j (6) (b).

By: Date:

Name:

Title:

Contractor Name:

Contractor Address:

Certifications and Standard Clauses

These Standard Clauses apply to all contracts, invitations for bid, requests for proposal (RFP), and requests for qualifications (RFQ) issued by the Western Regional Off-Track Betting Corporation (WROTB). Hereafter, the term “WROTB” shall be used to reference the Western Regional Off-Track Betting Corporation.

Independent Contractor The contractor shall perform services as an independent contractor and not as an officer, employee, or agent of WROTB. Nothing contained in this contract shall be construed as creating a relationship of employer and employee between WROTB and the contractor or any of its personnel.

Termination for Convenience WROTB reserves the right to terminate the contract for convenience and without cause, upon thirty (30) days’ written notice to the consultant. In the event of such termination, the consultant shall be entitled to compensation for goods or services satisfactorily provided up to the effective date of termination but shall not be entitled to recover any additional damages or anticipated profits on work not performed.

Termination for Cause WROTB reserves the right to terminate the contract immediately for cause if the proposer fails to perform its obligations, violates applicable laws or standards, or otherwise materially breaches the terms of engagement.

Compliance with Laws The proposer shall comply with all applicable federal, state, and local laws, rules, and regulations, including those of the New York State Gaming Commission, in connection with the performance of the contract.

Confidentiality The proposer shall treat as confidential all non-public information obtained during the course of the contract. Such information shall not be disclosed except as required by law, professional standards, or with the prior written consent of WROTB.

Records Retention and Work Product WROTB reserves the right to require proposers to maintain and provide access to records related to the contract, in a scope and for a period of time appropriate to the nature of the engagement. Such records may include, but are not limited to, documents relating to performance, deliverables, billing, and any final reports or work product produced under the contract.

Assignment and Subcontracting The bidder shall not assign, transfer, or subcontract any portion of the contract without the prior written consent of WROTB.

Indemnification To the fullest extent permitted by law, the successful proposer shall defend, protect, indemnify, and hold harmless WROTB, its affiliates and their respective directors, officers, employees, representatives and agents from any and all claims, actions, proceedings, investigations, losses, liabilities, damages (including, without limitation damage to property), injury to persons (including, without limitation, death) penalties, fines, costs and expenses (including, without limitation, attorneys’ fees and costs) relating in any way to (i)the proponent’s bid, (ii)any act or omission of the proponent relating in any way to its performance under the contract, and or (iii) and default of breach by the proponent, whether threatened, actual or alleged.

Non-Discrimination The proposer agrees that, in the performance of this contract, it will not discriminate against any employee or applicant for employment because of race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, marital status, veteran status, or any other characteristic protected by applicable federal, state, or local law. The bidder shall take affirmative steps to ensure that applicants are employed, and that employees are treated during employment, without regard to these protected categories.

Insurance and Workers’ Compensation The successful proposer shall furnish WROTB Certificates of Insurance indicating the type, amount, class of operations, coverage effective dates, and expiration dates of such policies. Such certificates shall also contain substantially the following statement:

“The insurance covered by this certificate will not be cancelled or materially altered except (a) after ten (10) days’ written notice has been received by WROTB and (b) the Unlimited Indemnity shown in the contract documents is included.”

WROTB shall be named as an additional insured on proponent-provided certificates. Insurance shall be primary and non-contributory.

The proposer shall be solely responsible for the payment of all required premiums and shall remain liable for any deductibles, self-insured retentions, or claims in excess of stated coverage limits.

WROTB reserves the right to modify or waive specific insurance requirements based on the nature of the agreement.

Non-Collusive Bidding By submission of a proposal, the proposer certifies under penalty of perjury that the prices in its proposal have been arrived at independently and without collusion, consultation, communication, or agreement with any other potential proponent or competitor for the purpose of restricting competition.

Governing Law This contract shall be governed by, and construed in accordance with, the laws of the State of New York.

No Arbitration Disputes involving this contract shall not be subject to mandatory arbitration. Any legal actions shall be brought in a court of competent jurisdiction in New York State.

Reciprocity and Sanctions Provisions The proposer certifies that it is not on any federal or state debarment or sanctions list and will immediately notify WROTB if it becomes subject to such restrictions during the term of the contract.

Final Agreement The proposer agrees and understands that this invitation for bid, and any addenda will be incorporated and become part of the final agreement.

PROPOSAL

Hereinafter known as OWNER.

Hereinafter known as BIDDER.

BE IT KNOWN:

BIDDER is thoroughly familiar with all provisionals and requirements of the Bidding Documents and the conditions under which the goods and services are required;

BIDDER finds that the proposed Contract Documents are complete, and that they are appropriate for the full, proper, and timely performance of the proposed Contract;

BIDDER possesses and commits to the Owner the technical knowledge, practical experience, management skills and all other resources that will be needed to provide the goods and perform the Work contemplated by, described in, and reasonably inferred from the proposed Contract Documents;

BIDDER represents that this bid is legitimate, and that the various documents which accompany the bid are accurate, complete and true.

NOW THEREFORE BIDDER HEREBY PROPOSES to furnish all supervision, labor, materials, services, tools, equipment, licenses, permits, and payments of lawful fees and taxes which may be necessary to fully perform the OWNER’S proposed contract.

PROPOSAL page 1 of 4

PART A: BASE BID SHEET

All in One Kiosk Cost Each $ Quantity 2 Total Cost $

Dispenser Spare Cassettes Cost Each $ Quantity 12 Total Cost $

MEI Spare Cassettes Cost Each $ Quantity 4 Total Cost $

Drop Card Cost Each $ Quantity 2 Total Cost $

Training Travel Charge Total Cost $

Backoffice Software Total Cost $

Annual Service Contract to be included in above cost.

Annual Software License to be included in above cost.

The bid price for this project is for a total bid price. All items required must have a bid price.

IN WORDS

PART B: OWNER’S EVALUATION OF BIDS

The Owner will determine the lowest, responsive, and responsible Bidder based on the lowest amount of the

TOTAL BASE BID PRICE.

“BIDDER MUST SUBMIT A COMPLETE PROPOSAL PACKET”

PROPOSAL page 2 of 4

PART C: ACKNOWLEDGEMENT OF ADDENDA

BIDDER acknowledges receipt of the following listed Addenda that have been issued for this Project. BIDDER warrants that this Bid fully accounts for all requirements, terms, and conditions of these Addenda. (BIDDER must type or print acknowledged Addenda numbers and dates (OR) check the box indicating that NO ADDENDA WERE RECEIVED.)

Addendum # Date Received:

Addendum # Date Received:

Addendum # Date Received:

NO ADDENDA WERE RECEIVED

PART D: CONTRACT TIME AND LIQUIDATED DAMAGES

The CONTRACT TIME shall be 30 calendar days, commencing on the day next following the Contractors receipt of the NOTICE TO PROCEED from the OWNER. It is agreed by the parties that this Contract time subsequently may be adjusted for cause with the terms and conditions of the General Conditions of the Contract.

PROPOSAL page 3 of 4

PART E: BIDDER’S EXECUTION OF PROPOSAL

The BIDDER, for good and valuable consideration namely the privilege of bidding for the OWNER’S proposed Contract, and the Owner’s assurance that the Contract will be awarded to the lowest responsible BIDDER, provided that the cost thereof would be within the amount budgeted and funded by the OWNER for the goods and services required, hereby offers this executed Proposal as a unilateral contract, with the understanding that it will become mutually binding if it is accepted by the OWNER.

Bidder’s Legal Name (as shown on Page 1)

(type or print)

(authorized signature)

(type or print name/title signed above)

Bidder’s Legal Address

(street address)

(City/Town, State, Zip Code)

(Phone)

(Email)

(Federal Tax ID or Social Security #)

END OF PROPOSAL

PROPOSAL page 4 of 4 image1.png