CITY OF SUN PRAIRIE

REQUEST FOR PROPOSALS

RFP #: 19-EMS27

Title: EMS Medical Direction

Department: Emergency Medical Services

Due Date: August 2, 2019

Table of Contents

I. NOTICE TO PROPOSERS

A. Summary

B. Important Dates

C. How to Submit a Proposal

D. Contact Information

E. Inquiries, Clarification & Exceptions

F. Addenda

G. Bid Distribution Networks

H. Local Vendor Preference

I. Oral Presentations/Site Visits/Meetings

J. Acceptance/Rejection/Withdrawal of Proposals

K. Public Record Law Compliance

L. Public Records Notice

M. Tax Exempt

N. Cooperative Purchasing

O. Terms of Contract

P. Cancellation/Termination of Contract

Q. Evaluation Process and Scoring

R. Insurance and Indemnification Requirements

II. DESCRIPTION OF RFP

III. REQUIRED INFORMATION

I. NOTICE TO PROPOSERS

A. Summary The City of Sun Prairie department of Emergency Medical Services is soliciting proposals from qualified vendors for EMS Medical Direction. Vendors submitting proposals are required to read this Request for Proposals “RFP” in its entirety and follow the instructions contained herein.

B. Important Dates Deliver proposals no later than the due time and date indicated below. The City will reject late proposals:

Issue Date: June 28, 2019 Questions Issue Date: July 16, 2019 Answers Posted Date: July 19, 2019 Due Date: August 2, 2:00 PM CDT

C. How to Submit a Proposal

Submit all required documentation in separate, sealed envelopes. Each envelope should be clearly marked as to the contents.

Hardcopy proposals typed and securely bound on 8.5 by 11-inch paper, otherwise identical to the electronic version (if applicable).

Electronic proposal in a PDF format stored on a common media (CD, DVD, or flash drive), identical in content and sequence to hardcopy proposal. Cost must be submitted separately.

Signature Affidavit (Form A): Five Copies Receipt of Forms (Form B): Five Copies Vendor Profile and Qualifications (Form C): Five Copies References (Form D): Five Copies

Cost Proposal (Form F): One Copy in separate sealed envelope Printed or Electronic Proposal: One Copy (Cost separately)

All proposal costs are the expense of the proposer. The City will not consider illegible proposals.

Elaborate proposals beyond that sufficient to present a complete and effective proposal, are not necessary or desired.

Complete and return Forms A through F to City of Sun Prairie Clerk’s Office by August 2, 2019, 2:00 PM CDT.

All proposals must be clearly labeled:

Proposer’s Name and Address

Title: EMS Medical Direction Due: August 2, 2019, 2:00 PM CDT

All email correspondence must include RFP # in the subject line.

Delivery of hard copies to: City of Sun Prairie Clerk’s Office 300 East Main Street Sun Prairie, WI. 53590 Delivery of electronic copy to: via email to treasurer@cityofsunprairie.com or on a commonly used media with the hard copies

Proposals must be delivered as instructed. Deliveries to other City departments and/or locations may result in disqualification.

Note: When mailing your response via a third party delivery service, the outside of the packaging MUST be clearly marked with the RFP name and number. This ensures that the bid can be delivered to the correct purchasing agent without having to open the bid.

D. Contact Information

The City of Sun Prairie Emergency Medical Services Department is the procuring agency:

Brian Goff City of Sun Prairie Emergency Medical Services 300 East Main Street Sun Prairie, WI. 53590 Phone: (608) 837-3604 Fax: (608) 825-0705 bgoff@cityofsunprairie.com

E. Inquiries, Clarification & Exceptions

Proposers are to raise any questions they have about the RFP document without delay. Direct all questions, in writing, to the department contact listed above in section D.

Proposers finding any significant ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFP document shall immediately notify the buyer and request clarification. In the event that it is necessary to provide additional clarification or revision to the RFP, the City will post addenda – see Addenda below. Proposers are strongly encouraged to check for addenda regularly.

mailto:treasurer@cityofsunprairie.com mailto:bgoff@cityofsunprairie.com

Proposals should be as responsive as possible to the provisions stated herein. A prospective vendor may take “exception” to bid terms, conditions, specifications and dates stated within the bid package. However, the City of Sun Prairie reserves the right to disqualify any and all bids submitted which include exceptions, if deemed not in the City’s best interests.

F. Addenda

In the event that it is necessary to provide additional clarification or revision to the RFP, the City will post addenda to the same websites as the original distribution – see G below. It is the proposer’s responsibility to regularly monitor the websites for any such postings. Proposers must acknowledge the receipt of any addenda on Form B. Failure to retrieve addenda and include their provisions may result in disqualification.

G. Bid Distribution Networks

The City of Sun Prairie posts all Request for Proposals, addenda, tabulations, awards and related announcements on two distribution networks – VendorNet and DemandStar. The aforementioned documents are available exclusively from these websites. It is the proposer’s responsibility to regularly monitor the bid distribution network for any such postings. Proposer’s failure to retrieve such addenda and incorporate their appropriate provisions in their response may result in disqualification. Both sites offer free registration to City proposers.

State of Wisconsin VendorNet System: State of Wisconsin and local agencies bid network.

Registration is free. http://vendornet.state.wi.us/vendornet

DemandStar by Onvia: National bid network – Free subscription is available to access proposals from the City of Sun Prairie and other Wisconsin agencies participating in the Wisconsin Association of Public Purchasers (WAPP). A fee is required if subscribing to multiple agencies that are not included in WAPP.

Home Page: www.demandstar.com

To Register: www.onvia.com/WAPP

Bid Opportunities: http://www.cityofsunprairie.com/504/Bid-Opportunities

H. Local Vendor Preference

The City of Sun Prairie may included a local vendor preference granting a scoring preference to local suppliers. The “local area” is defined as a physical address within City of Sun Prairie.

Exemptions and limitations may apply. Due to state law, buy local preference may not apply to public works projects. Due to federal restrictions, federally funded programs are also exempt.

Exemptions will also be made for emergencies, sole source purchases, cooperative purchasing agreements and cases in which a local vendor is not qualified as determined by City staff. If it is determined by City staff that a vendor has misrepresented its local status, it will be ineligible to receive preference.

http://vendornet.state.wi.us/vendornet http://www.demandstar.com/ http://www.onvia.com/WAPP http://www.cityofsunprairie.com/504/Bid-Opportunities

I. Oral Presentations/Site Visits/Meetings

Proposers may be asked to attend meetings, make oral presentations, inspect City locations or make their facilities available for a site inspection as part of this RFP process. Such presentations, meetings or site visits will be at the proposer’s expense.

J. Acceptance/Rejection/Withdrawal of Proposals

The City reserves the right to accept or reject any or all proposals submitted, in whole or in part, and to waive any informalities or technicalities, which at the City’s discretion is determined to be in the best interests of the City. Further, the City makes no representations that a contract will be awarded to any proposer responding to this request. The City expressly reserves the right to reject any and all proposals responding to this invitation without indicating any reasons for such rejection(s).

K. Public Record Law Compliance

It is the intention of City to maintain an open and public process in the solicitation, submission, review, and approval of contracts.

a. The parties acknowledge that City is a municipal corporation legally bound to comply with the Wisconsin Public Records Law and Open Meetings Law (see sections 19.32-19.39 and 19.81- 19.98, Wis. Statutes) and that, unless otherwise clearly allowed by law to be an exception to the Public Record Law and confidential, all aspects of this agreement are subject to open disclosure and are a matter of public record. It is further agreed to that neither party will take any action to obstruct the operation of these laws. To comply with any request under said Public Record Law, the provider/contractor herein shall produce copies of all materials, gathered or produced or modified pursuant to this Contract to City, in their original (i.e., electronic or digital, etc.) format at actual cost of reproduction, without profit. According to Wisconsin caselaw, even if records are created or maintained by, or in the custody of, the provider as an independent contractor, they, along with the raw data used to create the record, are nevertheless public records that must be made available to the public within a reasonable time and without delay upon request by any person, and in the format in which they were created. Provider/contractor agrees to hold City, its agents, officials and employees harmless and to indemnify them and City for all costs, fees, including all reasonable attorney fees and expenses of all kinds, and any judgments, orders, injunctions, writs of mandamus, and damages or expense of whatever kind for which City or its agents, officials or employees may expend or be held liable due to the Provider/contractor’s failure to comply with the Wisconsin Public Records and Open Meetings laws, or with this Agreement.

b. Any Public Records Law request received directly by a contractor related to this Contract with

City shall immediately be reported to the City Administrator.

L. Public Records Notice

Proposers are hereby notified that all information submitted in response to this RFP may be made available for public inspection according to the Public Records Law of the State of Wisconsin or other applicable public record laws. Information qualifying as a “trade secret” – defined in State of Wisconsin Statues – may be held confidential.

Proposers shall separately and clearly identify all information they deem to be “trade secrets”, as defined in the State of Wisconsin Statutes. Do not duplicate or co-mingle information deemed confidential and sealed, elsewhere in your response.

S. 19.36(5)

(5) TRADE SECRETS. An authority may withhold access to any record or portion of a record containing information qualifying as a trade secret as defined in s. 134.90(1)(c).

S. 134.90(1)(c)

(c) “Trade secret” means information, including a formula, pattern, compilation, program, device, method, technique or process to which all of the following apply:

1. The information derives independent economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use.

2. The information is the subject of efforts to maintain its secrecy that are reasonable under the circumstances.

The City cannot ensure that information will not be subject to release if a request is made under applicable public records laws. The City cannot consider the following confidential: a bid in its entirety, price bid information, or the entire contents of any resulting contract. The City will not provide advance notice to proposers prior to release of any requested record.

To the extent permitted by such laws, it is the intention of the City to withhold the contents of proposals from public view – until such times as competitive or bargaining reasons no longer require non-disclosure, in the City’s opinion. At that time, all proposals will be available for review in accordance with such laws.

M. Tax Exempt

The City of Sun Prairie as a municipality is exempt from payment of federal excise taxes and State of Wisconsin taxes per Wisconsin statue 77.54(9a). Federal Tax ID #39-6006382. A completed Wisconsin Department of Revenue Form S-211 (R.2-00) can be found on the City website. Our tax-exempt number is ES 42322.

N. Cooperative Purchasing

Bidders may choose to extend prices offered on bids to other municipalities. Under Wisconsin Statutes, a municipality is defined as a county; city; village; town; school district; board of school directors; sewer district; drainage district; vocational, technical and adult education district; or any other public or quasi-public corporation, officer, board or other body having the authority to award public contracts. This is known as “cooperative” or “piggyback” purchasing, a practice common amongst units of government. The City is not responsible for any contract resulting from a cooperative purchase using this RFP as a basis; they are made solely between the bidders and third party unit of government.

O. Terms of Contract

1. Term of Contract – The term of the contract shall be for a two (2) year period to commence on: January 1, 2020, ending on December 31, 2021.

2. Option to Extend – The City of Sun Prairie reserves the right to extend the contract for one (1) additional year, upon the same or more favorable terms and conditions, and under mutual agreement of both parties.

3. Contract Extension Pricing – Contract prices on an extended contract will be adjusted (escalated or deescalated) based upon the average annual change in the Consumer Index for “All Items” published by the Bureau of Labor Statistics (BLS) (Table 1A. Consumer Price Index for All Urban Consumers (CPI-U): U.S.

city average, by expenditure category and commodity and service group, Expenditure Category “All Items”). The CPI-U value is published by the BLS at its website: http://www.bls.gov/cpi/news.htm

The price for an option year shall be based upon the percent change in the CPI-U from the preceding year applied to the current contract year price to obtain the option year price.

The City of Sun Prairie reserves the right to discontinue the contract’s remaining option year and may elect to re-advertise the contract in whole or in part when changes in prices are not mutually acceptable between the contractor and the City.

Any and all changes to the contract terms and conditions shall be evidenced in writing by amending/modifying the contract.

4. Subcontracting Regulations – Successful vendor(s) will not be permitted to sublet, sell, transfer, assign or otherwise dispose of the contract or any portion therein, or its right, title or interest in, to any person, vendor or corporation.

P. Cancellation/Termination of Contract

The City of Sun Prairie may terminate the contract at any time at its sole discretion by delivering 30 days written notice to the contractor. Upon termination, the agency’s liability will be limited to the pro rata cost of the services performed as of the date of termination plus expenses incurred with the prior written approval of the agency. In the event that the contractor terminates the contract, for any reason whatsoever, it will refund to the agency within 30 days of said termination, all payments made hereunder by the agency to the contractor for work not completed or not accepted by the agency. Such termination will require written notice to that effect to be delivered by the contractor to the agency not less than 30 days prior to said termination.

http://www.bls.gov/cpi/news.htm

Q. Evaluation Process and Scoring

The RFP will be reviewed by the Evaluation Panel. A staff member from the Finance Department will oversee the evaluation process to ensure fairness within the process.

Each proposal will be evaluated as described below and assigned an overall score ranking.

Major Criteria Categories Point Weight Knowledge and experience with EMS medical direction in substantially similar agencies

Functional requirements and ability to meet and/or exceed stated objectives

Contractor’s team size, composition, qualifications, and number of team members assigned directly to the City’s contract

Contractor’s provision of value-added services, such as industry periodical subscriptions, clinical research opportunities, continuing education subscriptions, etc.

Clarity, detail, comprehensiveness, and aesthetic of contractor’s written proposal

Cost 5

TOTAL 100

R. Insurance and Indemnification Requirements

Insurance coverage shall be in place prior to commencing work and shall remain in force until the entire project is completed or the length of time that is specified in the contract. See Form E for requirements.

II. DESCRIPTION OF RFP

The purpose of this Request for Proposal is to obtain the services of a contractor that can provide licensed physician(s) to serve as the Medical Director pursuant to Chapter 256, Wisconsin Statutes, and Administrative Code Chapter DHS 110, to have authority over all clinical and patient care aspects of the Emergency Medical Services department for the City of Sun Prairie.

The City of Sun Prairie Emergency Medical Services department provides advanced life support service to a population of over 35,000 people within its 46 square mile primary response jurisdiction.

The department consists of 36 paramedic employees, and operates out of two locations. The department staffs two dual-paramedic ambulances 24/7 and one additional dual-paramedic ambulance during peak hours. Annual transports are approximately 2,000 per year out of a total of approximately 3,000 yearly calls for service.

The City of Sun Prairie has experienced significant levels of residential and retail growth in the past decade, as well as an expanding commercial and industrial base. Demand for EMS services increases regularly, and the City is seeking a robust medical direction program that supports its efforts to prepare for the future by developing skilled paramedic providers and reinforcing a flexible and dynamic EMS system as part of a comprehensive public safety program.

The minimum expectations of the contractor include, but are not limited to, the following work products and materials. At its own expense, the contractor shall provide all such personnel, technology, tools, and equipment required to achieve all work products and materials. Where contractor may require City resources to achieve same, such must be detailed in its Fee Proposal.

o Develop and Implement EMS Protocols o Provide EMS treatment protocols that are compliant with nationally accepted patient care standards.

o Review protocols annually and recommend updates/additions as appropriate to maintain compliance with nationally accepted patient care standards.

o Accept responsibility for the medical correctness of any standing order which contractor authorizes for use by the City.

o Provide Medical Direction o Ensure excellent clinical care through chart review, direct observation, quality assurance, and quality improvement processes and data analysis.

o Provide, or cause to be available, 24/7/365 physician consultation for paramedics during medical incidents.

o Provide field response as needed or requested, and periodically participate on scene calls with EMS crews.

o Furnish Training o Make an initial assessment, and provide written verification of, each paramedic’s knowledge and skills, and privilege to practice under the contractor’s medical license.

o Provide EMS training and continuing education sufficient to meet the state license renewal requirements for Wisconsin paramedics.

o Ensure that all service personnel meet the minimum state-required educational and skills competencies required and privilege to practice under the contractor’s medical license.

o Implement Quality Assurance o Regularly review records of service calls to determine compliance with protocols, performance standards, and regulations.

o Develop a standardized metric for the measurement of patient care delivery and compliance monitoring.

o Review and resolve clinical issues that may arise from, or be related to, the paramedics.

o Maintain Records o Provide reports to the City of all activities including site visits, training, scene responses, patient care, and service quality as requested.

o Maintain, and release to City upon request, all relevant records for EMS department monitoring and evaluation.

o Maintain and preserve until 10 years after contract termination, all documents, papers, audio, video, and other records related to the City and to permit access to any and all such records.

III. REQUIRED INFORMATION

Proposals shall include:

A. An estimated cost of additional professional fees and other related expenses that are anticipated.

All costs to be incurred by the City shall be clearly indicated (e.g., materials, software, staff hours, etc.). These costs should only be included on Form F- Fee Proposal.

B. A brief explanation of the contractor’s objectives and approach to EMS medical direction.

C. Information about value added services the contractor will make available to the City, such as industry periodical subscriptions, clinical research opportunities, continuing education subscriptions, etc.

D. Detail about the contractor’s participation in clinical research studies involving pre-hospital Emergency Medical Services.

This form must be returned with your response.

In signing Proposals, we certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit Proposals, that Proposals have been independently arrived at, without collusion with any other Proposers, competitor or potential competitor; that Proposals have not been knowingly disclosed prior to the opening of Proposals to any other Proposers or competitor;

that the above statement is accurate under penalty of perjury.

The undersigned, submitting this Proposal, herby agrees with all the terms, conditions, and specifications required by the City in this Request for Proposal, declares that the attached Proposal and pricing is in conformity therewith, and attests to the truthfulness of all submissions in response to this solicitation.

Proposers shall provide the information requested below. Include the legal name of the Proposers and signature of the person(s) legally authorized to bind the Proposers to a contract.

COMPANY NAME

SIGNATURE DATE

PRINT NAME OF PERSON SIGNING

J:/Finance/RFP/Form A Signature Affidavit.doc

Form A: Signature Affidavit

Proposers hereby acknowledge the receipt and/or submittal of the following forms:

Forms

Initial to Acknowledge

SUBMITTAL

Initial to Acknowledge

RECEIPT

Description of Services/Commodities N/A

Form A: Signature Affidavit

Form B: Receipt of Forms and Submittal Checklist

Form C: Vendor Profile

Form D: References

Form E: Insurance Requirements

Form F: Fee Proposal in separate sealed envelope

Appendix A: Standard Terms & Conditions N/A

Addendum #

Addendum #

Addendum #

VENDOR NAME

J:/Finance/RFP/Form B ReceiptofFormsandSubmittalChecklist.doc

Form B: Receipt of Forms and Submittal Checklist

COMPANY INFORMATION

Company Name (Make sure to use your complete, legal company name.)

FEIN (If FEIN is not applicable, SSN collected upon award.)

Contact Name (Able to answer questions about proposal.) Title

Telephone Number Fax Number

Email

Address City State Zip

ORDERS/BILLING CONTACT

Address where City purchase orders/contracts are to be mailed and person the department contacts concerning orders and billing.

Contact Title

Telephone Number Fax Number

Email

Address City State Zip

Form C: Vendor Profile/Qualifications

LOCAL VENDOR STATUS

The City of Sun Prairie may include a local vendor preference granting a scoring preference to local suppliers. Only suppliers within the City of Sun Prairie limits as of the bid’s due date will receive preference.

CHECK ONLY ONE:

� Yes, we are a local vendor.

� No, we are not a local vendor.

CORPORATION INFORMATION

If applicant is a corporation, please complete both columns:

Names of Corporate Officers Names of Corporate Directors

LICENSES AND PROFESSIONAL REGISTRATION

List names of each key person of the firm. If a requested service requires a licensed/registered practitioner, you will be required to provide a copy of such license/registration before work can begin.

Name

Capacity

(Owner, Partner, Etc.)

Current Licenses/Registrations (Include Certificate # if applicable)

License/Registration

Expiration Date

Name

Capacity

(Owner, Partner, Etc.)

Current Licenses/Registrations (Include Certificate # if applicable)

License/Registration

Expiration Date

CONFLICT OF INTEREST

A conflict of interest may exist where an employee or close relative/family member has a connection to your business, and a third party may consider that this relationship may compromise the competitive process. Does any employee of your company have a possible conflict of interest with this process? Yes No If yes, please specify the following:

Employee Name: __________________________ Employee Phone Number: _______________

Employee’s Relationship: _________________________

PRIOR WORK

Has your organization ever performed work for the City of Sun Prairie? Yes No If yes, please specify scope of work:

WORK EXPERIENCE

List contracts for similar services or materials that have been completed within the last five years. On a separate page, if necessary, describe each EMS agency listed in terms of whether public or private, fire-based or third-service, number of providers and their certification levels, annual call volume, population served, and size of jurisdiction.

Project Location Type of Service Total Amount of Contract

Completion Date

Name/Phone of Owner or Other

References

KEY PROJECT PERSONNEL INFORMATION

Provide the requested information for key personnel who would be assigned to work directly on contracts awarded or who would, at a minimum, supervise such work.

Name and Title Primary Responsibilities

Years of Experience

Education (Degrees, Certificates)

Other Relevant Experience and/or

Qualifications

JUDGEMENTS AND CLAIMS

Are there any judgements, claims or suits pending our outstanding against you or your organization?

Yes No

If yes, please explain:

DISPUTES REGARDING LIENS

Has any owner or higher-tier contractor with whom your business has had a contract ever disputed a claim of lien filed by you or your organization? Yes No

RECEIVERSHIP

Have you or your organization filed for bankruptcy, receivership, or reorganization within the last five years?

Yes No

LEGAL INFRACTIONS

Have you or your organization been cited and/or fined for failure to comply with federal or state regulations and/or statues in the past two years? Yes No

Information provided in this application may be audited by the City of Sun Prairie.

Provision of information on Form C does not relieve your company from providing the same or additional information as requested in a response to a request for proposal.

Submittal of Form C does not guarantee qualification. Qualification will be given only if your company meets all statutory, regulatory or City requirements, including those not listed on this application. Qualification does not guarantee your company any business.

Your company must update significant information changes in writing within 30 days.

Significant changes include, but are not limited to: change of legal status, TIN, ownership, name, address, as well as loss of licensure or registration, filing of bankruptcy, or suspension by any federal, state, or local government agency.

Failure to provide accurate and reliable information required by this form may, in accordance with any and all applicable laws, result in penalties including, but not limited to, suspension or debarment from doing business with the City of Sun Prairie and termination of contracts.

J:/Finance/RFP/Form C Vendor Profile/Qualifications.doc

Reference # 1 – Client Information Company Name

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

Contract Period Year Completed Total Cost

Description of the Performed Work

Reference # 2 – Client Information

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

Contract Period Year Completed Total Cost

Description of the Performed Work

Form D: References

Reference # 3 – Client Information

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

Reference # 4 – Client Information

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

Reference # 5 – Client Information

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

Reference # 6 – Client Information

Contact Name

Address City State Zip

Telephone Number Fax Number

Email

J:/Finance/RFP/Form D References.doc

Prepare the Fee Proposal to include the following:

1. All Inclusive – Covers all direct and indirect necessary expenses for each section.

2. Not to Exceed – The actual fees shall not exceed the amount specified on each line of the fee proposal.

a. Work product and materials: $ ___________________________

b. Estimated costs to be incurred by the City $ ___________________________

3. Will Vendor accept credit card for payment with no additional fees?

________ Yes _______ No

4. Will Vendor accept payment via Electronic Funds Transfer (EFT)?

5. Will Vendor allow Piggybacking of this contract to other government agencies?

The above fees shall be compensation for all the services provided pursuant to this agreement. The cost for project deliverables shall be included as part of the costs above. This fee includes all necessary meetings with the City Council and such Committees, Boards, and Commissions as required. All costs incurred by the contractors and all sub-contractors are included herein.

Any additional services over and above the services described in this agreement shall be provided only when authorized in writing by the City’s designated representative.

For additional services, provide the hourly rate for all staff positions (ie – Engineer

Form F: Fee Proposal

Technician, Project Engineer, etc.) that may be designated for this project and any overhead rates that would apply:

The undersigned, submitting this Proposal, herby agrees with all the terms, conditions, and specifications required by the City in this Request for Proposal, declares that the pricing is in conformity therewith, and attests to the truthfulness of all submissions in response to this solicitation.

Proposers shall provide the information requested below. Include the legal name of the Proposers and signature of the person(s) legally authorized to bind the Proposers to a contract.

COMPANY NAME

SIGNATURE DATE

PRINT NAME OF PERSON SIGNING

J:/Finance/RFP/Form F Fee Proposal.doc