ADEQ18-189203

City of El Mirage — Regular Meeting (2020-12-01)

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Request for Pro posals

Solicitation No. Arizona Department of

ADEQ18-00007515 Environmental Quality
Description: 1110 W. Washington Street

Asbestos and Lead Consultant and Phoenix, AZ 85007
Abatement Services

Attachment 1
Offer and Acceptance Form

SUBMISSION OF OFFER: Undersigned hereby offers and agrees to provide Asbestos Services in compliance with the Solicitation
indicated above and our Offer indicated by the latest dated version below:

Original Offer:

date initial
Revised Offer:

date #1 initial date #2 Initial date #3 initiat
Best and Final Offer; % 29) 2o/ 7

date initial

Dominion Environmental Consultants, Inc.

Company name Signature of person authorized to sign Offer Initials
20045 North 19" Avenue, Building 7 Vern L. Crow, President

Address Printed name and title
Phoenix, AZ 85027 Vern L, Crow, President

City | State | ZIP Contact name and title
www.dominion-env.com row@ inion- q 623-516-1415

Company website Contact Email Address Contact phone number

CERTIFICATION: By signature in the above, the Offeror certifies that it:

1. will not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, [Arizona] Stete
Exacutive Ordar 2009-9 or A.R.S. §§ 41-1461 through 1465;

2, has not given, offered to give, nor intands to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity,
special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature
affirming the stipulations required by this clause will result in rejection of the Offer. Signing the Offer with a false statement will void the
Offer, any resulting contract, and may be subject to legal penalties under law;

3. compiles with A.R.S. § 41-3532 when offering electronics or information technology products, services, or maintenance; and

4. is not debarred from, or otherwise prohibited from participating In any contract awarded by federal, state, or local government.

ACCEPTANCE OF OFFER: State hereby accepts the Offer. Offeror is now bound (as Contractor) to sell the Materials and perform the
Services under the attached Contract, of which the Accepted Offer forms a part. Contractor |s cautloned not to commence any billable work
or to provide any material or perform any service under the Contract until Contractor receives the applicable purchase order, release

document, or written notice to proceed.
State's Contract No. is; ADEQ18-189203 The effective date of the Contract is: November 29, 2017
(for all correspondence and invoices)

Contract awarded thie 29th day _ November __ 2947

PART 4 of the Solicitation Documents

Offer Forms (Attachments) Date: July 18, 2017 4
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