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15 <br />Certifications <br />Ew <br />CITY OF SANTA ANA <br />ATTACHMENT A <br />PROPOSERS CERTIFICATION, PROPOSAL ITEM PRICING <br />Certification • I certify that I have read, understand and agree to the terms and conditions of this Request <br />for Proposals. I have examined the Scope of Services (Exh" 1) and am qualified to provide services <br />being requested as specdted herein I understand and agree that 1 am responsible for reporting any <br />errors. omissions or discrepancies to the City for clarification prior to the submission of my proposal. <br />PROPOSERS STATEMENT I have read, understood and agree to Une terms and conditions on all <br />pages of the Request for Qualifications. Upon request-1 will transfer and deliver goods or services to the <br />City in accordance with sad terms and conditions <br />DTSA Services 714-612-9227 <br />LEGAL NAME OF COMPANY PHONE AND FAX <br />201 E 4th Street Santa Ana CA 92701 <br />BUSINESS ADDRESS <br />Jose Romo General Manager <br />PRINTED NAME OF AUTHORIZED AGENT TITLE <br />' r L._�. - January 7, 2023 romo9227Cgmall corn <br />SIGNATURE OF AUTHORIZED AGENT DATE E-MAIL ADDRESS <br />FEDERAL ID NUMBER (IF APPLICABLE) CONTRACTOR LICENSE NUMBER <br />i1FAPPLICABLEt <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP No 22-168 Dotrntotvo Santa Ana Clean A Safe Team 38 <br />