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RFP 13-015 <br />PRICE SUMMARY FORM Page 2 continued <br />PROPOSER STATEMENT: I have read, understood and agree to the terms and conditions on <br />all pages of the RFP. Upon request I shall transfer and deliver goods or services to the City in <br />accordance with said terms and conditions. <br />Complete Legal Name of Company Phone Number Fax Number <br />Business Address <br />City/State Zip Code <br />Signature of Authorized Proposer Printed Name Date <br />Title of Authorized Proposer <br />Phone Number <br />23 <br />25A-34