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Attachment B <br />Proposal Declaration and Acknowledgement <br />Required <br />Respondent must complete and submit this Attachment as the response cover page. <br />Check to confirm statements are true: <br />1. No attempt has been made or will be made by us to induce any other <br />person or firm to not submit Qualifications in response to this RFQ. <br />2. No personnel currently employed by the City of Roseville participated, <br /> <br />directly or indirectly, in any activities related to the preparation of this <br />Submittal. <br />3. To the best of our knowledge there are no relevant facts or circumstances <br /> <br />which could give rise to organizational conflicts of interest. <br />4. Respondent has reviewed and is familiar with this RFQ and its <br />attachments. <br /> <br />5. Respondent understands and acknowledges all RFQ requirements. <br /> <br />6. Respondent is able to furnish Bonds and Insurance required by this RFQ. <br />7. Respondent is NOT currently debarred, at a State or Federal level, from <br /> <br />doing business with public entities. <br />8. The Respondent understands they shall not assign any part of its interest <br /> <br />in the Contract without prior written consent of the City of Roseville <br /> <br />9. Respondent is able to start project as noted in the included timeline <br />I certify under penalty of perjury that I am a duly authorized representative of the Respondent <br />listed below, I have carefully examined all RFQ Documents and documents referenced in this <br />RFQ, I understand all instructions, requirements, specifications, terms and conditions, and all <br />statements, information, costs, and schedules submitted in response to the RFQ are current, <br />complete, true and accurate. I am in full compliance with all applicable Federal, State and local <br />laws, rules, regulations and ordinances governing my business practices. <br /> <br />Legal Name of Firm and type of business Date of Submission <br /> <br />Printed Name of RespondentÓs Signature of RespondentÓs Representative <br />Representative and Title <br /> <br />E-mail Address of Respondent FirmÓs Phone Number <br /> <br />FirmÓs Mailing Address <br />B-1 <br />Qbhf!312!pg!:15 <br /> <br />