Orange County NC Website
Browse       Search
DocuSign Envelope ID:41 B27956-1 C1 7-475E-9558-D6D38ABE1436 <br /> RESPONDER'S CERTIFICATION FORM <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 /> I 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: <br /> BY: (printed name) <br /> SIGNATURE: <br /> MAILING ADDRESS- <br /> CITY/STATE/ZIP CODE: <br /> TELEPHONE NUMBER: <br /> FAX NUMBER: <br /> ACKNOWLEDGEMENT OF ADDENDA <br /> Responder hereby acknowledges receipt of all Addenda through and including: <br /> Addendum No. Date Acknowledgement <br /> Page 10 of 12 <br />