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Attachment D <br />Respondent Questionnaire <br />Instructions <br />Use this form (available in Word format with expandable text fields for your answers) and <br />attach additional pages as necessary to respond to each of the following questions. All <br />Respondents must complete this Questionnaire. If any items are Not Applicable, please <br />mark the Section "N/A". <br />Note: If this is a teaming arrangement, list all team members, providing: organization <br />name, contact person name, address, telephone number, email, website, and contact <br />person. The word "company" as used below includes partnerships, corporations, sole <br />proprietorships, and/or other types of organizations. <br />General Contact Information: <br />Name of Company Proposing: <br />Address: <br />Telephone: <br />Email: <br />Website: <br />Name of contact person: <br />Type of organization: <br />(e.g., corporation, joint venture, partnership, <br />Neighborhood Recycling Corp., dba Eureka Recycling <br />2828 Kennedy St NE, Minneapolis, MN 55413 <br />612-455-9120 <br />joannas@eurekarecycling.org <br />www.eurekarecycling.org <br />Joanna Stone <br />501(c)3 Non -Profit Organization <br />Is this a "Team" proposal? ❑ Yes ® No <br />If yes, list the name(s) of the other organizations proposing as a part of your Team. (A <br />letter of intent to team should be included from each organization.) <br />1. NA <br />2. NA <br />3. NA <br />References <br />Provide on separate page(s) Recycling collection service references. Provide at least three <br />(3) municipal references. Include: <br />♦ The name of the municipality or other government agency <br />♦ Dates of service <br />♦ Number of households served <br />♦ Contract structure between the organization and current status <br />RFP for City of Roseville Recycling Services • D-1 <br />pw:\\PW-APS1.foth.com:PW_IE\Documents\Clients\Ramsey Co PH MN\0020R003.00\10300 Draft Documents\ <br />Roseville RFP 2020 - 2021\2020 - 2021 RFP PacketVDRAFT Questionnaire - Attachment D - 1-19-2021.docx <br />