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149 <br />I have carefully examined the Request for Qualifications, the sample Agreement for Design <br />Consultant Services and any other documents accompanying or made a part of this Request for <br />Qualification. <br />1 hereby propose to furnish the professional design consultant services for Orange County in <br />accordance with the instructions, terms, conditions, and requirements incorporated in this Request for <br />Qualification. I certify that all information contained in this response is truthful to the best of my <br />knowledge and belief. I further certify that I am duly authorized to submit this response on behalf of <br />the firm as its act and deed and that the firm is ready, willing and able to perform if awarded the <br />contract. <br />NAME OF FIRM: t1/)6A3 A rai -[ccf-u rc-, <br />BY: (printed name <br />SIGNATURE: <br />MAILING ADARES6" 1�1n () n VVC� j <br />J <br />CITY/STATE/ZIP CODE: <br />TELEPHONE NUMBER: <br />FAX NUMBER: <br />Responder hereby acknowledges receipt of all Addenda through and including: <br />Addendum No. Date Ack <br />/eedg ement <br />/Z Jo ' W-F <br />V t <br />Page 10 of 11 <br />