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it of LaPorte <br />Est-kllsk,d 1892 <br />Exhibit A Pricing to Sealed Bid #19005 <br />PurckasinRDepartment <br />Cherell Daeurner, Purchasing Manager <br />NOTE: Please itemize any other additional fees or charges. Any charges not included in this proposal will not be <br />Alowed. Attach additional sheet if necessary. <br />Item Description Lump Sum Bid <br />Lump Sum Price for Addition to Existing Fire Field Training <br />Facility, complete, as per approved specifications :Z& <br />The undersigned certifies: <br />1. to comply with all instructions to bidders, attached specifications and other documents contained in this <br />solicitation; <br />2. that they have not conspired with any other potential supplier in any manner to attempt to control <br />competitive pricing; <br />3. that they are a duly qualified, capable and bondable business entity not in receivership or contemplating <br />same, and has not filed for bankruptcy. <br />4. affirms that they will not discriminate against any employee or applicant as prohibited by law. Failure to <br />comply may lead to termination of contract. <br />It is understood and agreed that the above described item, material, equipment and/or work shall carry the <br />standard warranty of the manufacturer and be delivered on site in accordance with the attached specifications in <br />4 <br />days after receipt of order. <br />C!W tf <br />approved invoice) <br />Do you allow for payments using the City's Procurement Card Provider, CitiBank (this is the preferred payment <br />method in many instances)? 4/ A`+ If "yes", discount offered % <br />V <br />Company Name: Authorized Signer: '91�ZSt�j 'L&," A <br />A <br />0 6-A <br />,na-in; :vz (Printed Name) <br />Telephone No: r iD z, Li-) Authorized Signer: <br />(Signature) <br />E-mail: 2- 1 eC_ L Z�Zc '(�"q C)L, , fr) <br />