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Attachment D Respondent Questionnaire Instructions Use this form (available in Wordformat with expandable text fields for your answers) and attach additional pages as necessary to respond to each of the following questions. All Respondents must complete this Questionnaire. If any items are Not Applicable, please mark the Section “N/A”. Note: If this is a teaming arrangement, list all team members, providing: organization name, contact person name, address, telephone number, email, website, and contact person. The word “company” as used below includes partnerships, corporations, sole proprietorships, and/or other types of organizations. General Contact Information: Name of Company Proposing: Click or tap here to enter text. Address: Click or tap here to enter text. Telephone: Click or tap here to enter text. Email:Click or tap here to enter text. Website: Click or tap here to enter text. Name of contact person: Click or tap here to enter text. Type of organization: Click or tap here to enter text. (e.g., corporation, joint venture, partnership, individual) Is this a “Team” proposal? Yes No If yes, list the name(s) of the other organizations proposing as a part of your Team. (A letter of intent to team should be included from each organization.) 1. Click or tap here to enter text. 2.Click or tap here to enter text. 3. Click or tap here to enter text. References Provide on separate page(s) Recycling collection service references. Provide at least three (3) municipal references. Include: The name of the municipality or other government agency Dates of service Number of households served Contract structure between the organization and current status RFP for City of Roseville Recycling Services D-1 pw:\\\\PW-APS1.foth.com:PW_IE\\Documents\\Clients\\Ramsey Co PH MN\\0020R003.00\\10300 Draft Documents\\ Roseville RFP 2020 - 2021\\2020 - 2021 RFP Packet\\DRAFT Questionnaire - Attachment D - 1-19-2021.docx Qbhf!275!pg!557