ADEQ18-186330

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

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Request for Proposals
Solicitation No.
ADEQ18-00007515
Description:

Asbestos and Lead Consultant and
Abatement Services

Arizona Department of
Environmental Quality

1410 W. Washington Street
Phoenix, AZ 85007

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 ee version below:

Original Offer: August §, 2017
date initial
Revised Offer: ~ - = ~
date #1 ini bal date #2 initial date #3 initial
) -
Best and Final otters ff GLUT eae
date initial
Western Technologies Inc, ft) hf, XK Cherber
esterr gle: tha
Company name Signature of pers; one lo sign Offer Initials
3737 East Broadway Road Vicky L. Aviles, an Environmental PM
Address Printed name and title
Phoenix, Arizona 85404 Vicky L. Aviles, Principal/Senior Environmental PM
City | State | ZIP Contact name and title
www.wt-us.com Vicky.a@wt-us.com 602-437-3737 ext. 123
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 Execulive Order 11246, [Arizona] State
Executive Order 2009-9 or A.R.S. §§ 41-1461 through 1465;

2. has not given, offered to give, nor intends to give at any lime 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 penallies under law;

complies 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 par. Contractor is cautioned 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:__ DEQI8-186330 The effective date of the Contract is: November 1, 2017

(for all correspondence and invoices)

Contract awarded this _ 2314 day ot_ October 2017
Teena Ziegler, crfo, gers //
Chief Procureme: icer

PART 4 of the Solicitation Documents:

Offer Forms (Attachments) Date: July 18, 2017 4
Page 2 of 33

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