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0 City of Santa Ana <br />ITEM 1: COVER LETTER <br />(4 PAGE LIMIT) <br />Please include a cover letter, on official Proposer letterhead, that describes the Proposer and its <br />qualifications. <br />A. The official name of the Proposer; <br />B. The Proposer's organizational structure (e.g. corporation, partnership, limited liability <br />corporation, or otherwise); <br />C. The jurisdiction in which the Proposer is organized and the date of such organization; <br />D. The address and telephone number of the Proposer's headquarters and of any local office <br />involved in the bid proposal; <br />E. The Proposer's Federal Tax Identification Number; <br />F. The name, address, telephone, fax numbers and e-mail address of the person(s) who will serve <br />as the authorized contact(s) to the City of Santa Ana and OCFA with regards to the bid <br />proposal, the RFP process, the Contract Documents, and the administration of the contract, if <br />awarded, with authorization to make representations on behalf of and to bind the Proposer; <br />G. Provide applicable authorized signature documentation, pursuant to Proposer's organizational <br />structure/bylaws, verifying the authority of the person signing the original bid proposal to <br />commit to the proposal on behalf of the Proposer (attach to cover letter); <br />H. A representation that the Proposer is in good standing in the State of California and has <br />obtained all necessary licenses, permits, certifications, approvals and governmental <br />authorizations necessary in order to perform all of the required performance obligations <br />specified in the RFP; <br />1. A representation that the Proposer is in good standing in the Medicare and Medi-Cal programs <br />and is not the subject of any pending actions, investigations or prosecutions, whether civil, <br />criminal or administrative, relating to their billing or reimbursement practices, and that <br />Proposer has not been excluded from any state or federal healthcare program or employs any <br />individual who has been excluded from any state or federal healthcare program; <br />J. Statement of acceptance of all terms, conditions, requirements, and performance criteria <br />contained in the Contract Documents; and, <br />K. Any additional information Proposer deems relevant for consideration during the selection <br />process. <br />Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 57 <br />June 14, 2012 <br />25F-76