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AAu of Cirreeda—sepe tMMtaf coamei xei~Mrumment WMW Sordidlon NumWr__ <br />65Pbaa-tAtgIFVOe/a9) <br />BIDDER DECLARATION <br />1. Prime bldderinformation(RaWawattachad Bidder Declaration Instructions pdor to completion of this tram); <br />a. Identify current California eertifeatlon(s) IWO, tNVSA, DVAEls or Mono II (If"Nane;gotnitem M2) <br />'b. Will subcontractors be used for this contract? Yesf]No❑(Ifyes,Indlcate the distinct element of work your firm will perform In this contract <br />e.g„ list the proposed product's produced by your firm,state If your fine owns the transportation vehicles that will dellverthe products to the State, <br />Identify which solicited services your firm will peftm,etc.). Use additional sheets, as necessary, <br />c, Ifyou area California certified OV611: (1) Are you a broker or <br />(2) If the contractlnclud <br />provided In this contract <br />7.. If no subcontractors will be usod, skip to (UtIficatlon below, Otherwise, list all subcontractors for this contract.(Attadf additional noes if nacacsa,v4 <br />S cmhacerNane(W%c[Pesan, <br />Phone Number&fax Number <br />Subcanuauarbldress <br />&Anall Address <br />Wistpkadan(MQSli, <br />NVS4,Marli ne) <br />Walkpedmnedorgoodsprovlded <br />mthisastrao <br />rarmspoeding <br />%of bid prkm <br />riaod <br />Standing <br />St% <br />RastaR <br />0% <br />❑ <br />0% <br />CkBTIFICATION: Byslgning the bid rusponsa,l cwrdfy under penalty of perjurythat the information provided is up" and Correct, <br />