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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 />Reaular Unleaded Gasoline <br />Gasoline prices (four decimal places, i,e. 0.0000) <br />87 OCTANE <br />Bulk fuels full truck and trailer <br />OPIS Plus <br />Or Minus <br />Delivery <br />Other (specify) <br />Applicable Discount(s) <br />Total OPTS + <br />Smaller Tank less than full truck <br />OPIS Plus <br />Or Minus <br />Delivery <br />Delivery size: 7,000+ gallons <br />cents per gallon <br />C- cents per gallon <br />C ' cents per gallon <br />cents per gallon <br />cents per gallon <br />o E 2 net cents per gallon <br />Delivery size: 3,500 - 6,999 gallons <br />cents per gallon <br />cents per gallon <br />cents per gallon <br />Other (specify) cents per gallon <br />Applicable Discount(s) _ cents per gallon <br />Total OPTS + j, osil net cents per gallon <br />E <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 invoices during the contract. <br />RFP 17-108 Fuel - Gasoline and Diesel <br />Pane 19