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ATTACHMENT A - PROPOSAL DECLARATION AND ACKNOWLEDGEMENT Required Respondent must complete and submit this Attachment as the response cover page. Check to confirm statements are true: 1. The Respondent has reviewed the A133, and A 201 Contract referenced in section 1.2. 2. No attempt has been made or will be made by us to induce any other person or firm to not submit a Proposal in response to this RFP. 3. No personnel currently employed by the City participated, directly or indirectly, in any activities related to the preparation of this Submittal. 4. To the best of our knowledge there are no relevant facts or circumstances which could give rise to organizational conflicts of interest. 5. Respondent has reviewed and is familiar with this RFP. 6. Respondent understands and acknowledges all RFP requirements. 7. Respondent is able to furnish Bonds and Insurance required in the RFQ. 8. Respondent is NOT currently debarred, at a State or Federal level, from doing business. 9. The Respondent understands they shall not assign any part of its interest in the Contract without prior written consent of the City I certify under penalty of perjury that I am a duly authorized representative of the Respondent listed below, I have carefully examined all RFP Documents and documents referenced in this RFP, I understand all instructions, requirements, specifications, terms and conditions, and all statements, information, costs, and schedules submitted in response to the RFP are current, complete, true and accurate. I am in full compliance with all applicable Federal, State and local laws, rules, regulations and ordinances governing my business practices. Legal Name of Firm Date of Submission Printed Name of Respondent’s Signature of Respondent’s Representative Representative E-mail Address Phone Number Mailing Address Roseville MOC and LPCDS A-1 PW25-01 RS160\\21\\1038443.v3 Qbhf!352!pg!:15