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<br /> Disaster Debris Clearance and Removal Services <br />Bid: 5266, Orange County, North Carolina <br />July 29, 2019 Page 42 <br /> <br /> <br /> <br />Proposer’s Bid Certification Form <br />To Whom It May Concern: <br />I have carefully examined the Request for Proposal and any other documents accompanying or make a part of this <br />Request for Proposal. <br /> <br />I hereby propose to perform the following Services as specified in this Request for Proposal No. Q19-39 at the rates <br />described on SCHEDULE 1 – UNIT RATE PRICE SCHEDULE and SCHEDULE 2 – HOURLY EQUIPMENT AND LABOR PRICE <br />SCHEDULE. <br /> <br />I certify that all information contained in this proposal is truthful to the best of my knowledge and belief. I further <br />certify that I am duly authorized to submit this proposal on behalf of the company as its act and deed and that the <br />company is ready, willing and able to perform if awarded the contract. <br /> <br />I further certify, under oath, that this proposal is made without prior understanding, agreement, connection, <br />discussion, or collusion with any other person, firm or corporation submitting a proposal for the same product or <br />service; no officer employee or agent of the Town or any other proposer is interested in said proposal; and that the <br />undersigned executed this Proposer’s Certification with full knowledge and understanding of the matters therein <br />contained and was duly authorized to do so. <br /> <br />This is an acknowledgement that FEMA financial assistance will be used to fund the contract only. The Contractor will <br />comply with all applicable federal laws regulations, executive orders, and the latest version of FEMA policies, <br />procedures, and directives. <br /> <br />It is distinctly understood that the Town reserves the right to reject any or all proposals. <br /> <br />_________________________________ Federal Tax ID: ______________________ <br />Company Name <br /> Phone: _____________________________ <br />_________________________________ <br />Authorized Signature Fax: _______________________________ <br /> <br />_________________________________ Email: _____________________________ <br />Printed or Typed Name and Title <br /> NOTARIZE <br />_________________________________ Subscribed and sworn to before me this ______ <br />Mailing Address day of__________________, 2019 <br /> <br />_________________________________ Notary Public________________________________ <br />City/State/Zip Code <br /> My Commission expires: _______________________ <br /> <br /> <br />(SEAL, if Corporation) <br />DocuSign Envelope ID: 5FA4B1AC-B897-4C32-A1E4-4B4A8885A341