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EXHIBIT C <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR ON -CALL SEWER AND WATER SYSTEM REPAIR SERVICES <br />PROPOSERS CERTIFICATION and PROPOSAL ITEM PRICING <br />Certification - I certify that I have read, understand and agree to the terms and conditions of this Request for <br />Proposals. I have examined the Scope of Services (Exhibit A) and am familiar with the scope of work <br />locations. I am familiar with all the existing conditions and limitation that may impact work requests. I <br />understand and agree that I am responsible for reporting any errors, omissions or discrepancies to the City for <br />clarification prior to the submission of my proposal. <br />Proposal Item Price - Pricing shall be based on a (hourly cost, time and materials basis - see narrative) <br />for services described in Exhibit A. Fee must be inclusive of all costs, including but not limited to, direct and <br />indirect costs for labor, overhead, incidental supplies, travel, mileage, and fuel. Any special materials will be <br />purchased by the contractor only after discussed and authorized by the City projects manager or designee in <br />writing. <br />Proposer shall attach a separate hourly rate schedule with hourly rates for staff per mob classification <br />and equipment. <br />The use of Subcontractors is allowed but will require approval by City prior to start of any assigned work. <br />When a Subcontractor performs all or any part of the work, a markup shall be applied to the Subcontractor's <br />actual cost of such work. The Contractor may add a markup of 10 percent on the first $5,000 of the <br />subcontracted portion of the extra work and a markup of 5 percent on work added in excess of $5,000 of the <br />subcontracted portion of the work. <br />LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS <br />BUSINESS ADDRESS <br />PRINTED NAME OF AUTHORIZED AGENT <br />AUTHORIZED AGENT DATE E -MAIL ADDRESS <br />FEDERAL ID NUMBER (IF APPLICABLE) ENVIRONMENTAL LABORATORY ACCREDIDATION <br />PROGRAM CERTIFICATE NUMBER (ELAP #) <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 #14 -044 — On -Call Emergency Sewer and Water System Repair Services <br />25R91160 <br />