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CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS 17.108 <br />FUEL — GASOLINE AND DIESEL <br />BID FORM <br />PRICING SHEET <br />Regular Unleaded Gasoline <br />Gasoline prices (four decimal places, ii,e. 0.0000) <br />87 OCTANE <br />Bulk fuels full truck and trailer Delivery size: 7,000+ gallons <br />OPIS Plus cents per gallon <br />Or Minus .3 0, o <br />cents per gallon <br />Delivery cents per gallon <br />Other (specify) cents per gallon <br />Applicable Discount(s) cents per gallon <br />Total OPIS + net cents per gallon <br />Smaller Tank less than full truck Delivery size: 3,500 — 6,999 gallons <br />OPIS Plus cents per gallon <br />Or Minus cents per gallon <br />Delivery 1� cents per gallon <br />Other (specify) cents per gallon <br />Applicable Discount(s) cents per gallon <br />Total OPIS + og net cents per gallon <br />Large bulk deliveries exceeding 7,000 gallons could include a combined load of gasoline and <br />diesel. <br />Please indicate any split load surcharges in the other category if applicable. Split load <br />surcharges not stated herein will not be allowed on any invoirp-,g during the contrRet. <br />City Council 19-17 1.0/4/2022 <br />RFP 17-108 Fuel -Gasoline and Diesel <br />Pace 19 <br />