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CITY OF SANTA ANA <br />ATTACHMENT A <br />PROPOSER'S CERTIFICATION, PROPOSAL 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 (Exhibit 1) and am qualified to provide services <br />being requested as specified herein. I understand and agree that I am responsible for reporting any <br />errors, omissions or discrepancies to the City for clarification prior to the submission of my proposal. <br />PROPOSER'S STATEMENT: I have read, understood and agree to the terms and conditions on all <br />pages of the Request for Proposals. Upon request, I will transfer and deliver goods or services to the <br />City in accordance with said terms and conditions. <br />Inland Moving and Storage Co., Inc. (951) 682-4300 - Office <br />DBA Burgess Moving and Storage (951) 369-1880 - Fax <br />LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS <br />1625 Iowa Ave, Riverside, CA 92507 <br />BUSINESS ADDRESS <br />Tim Burgess President <br />PRINTED NAME OF AUTHORIZED AGENT TITLE <br />SA a3 tburgess@burgessmoving.com <br />SIGNATURE OF AUTHORIZED AGENT DATE E-MAIL ADDRESS <br />95-1841836 N/A <br />FEDERAL ID NUMBER (IF APPLICABLE) CONTRACTOR LICENSE NUMBER <br />(IFAPPLICABLE) <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. 23-058 Library Moving and Storage Services Page 34 of 40 <br />