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QUOTATION FORM <br />Project Toe Eugene Depot -Temporary Facilities <br />Location 433 Willamette St. <br />CitylState/Zip Eugene Oregon, 97441 <br />Page 1 of 2 <br />Provide Time and Iviatcrials, Not to.Exceed quotations on this form for the work described on the <br />attached Request for Quotation. Quote shall be signed with firm name and official signature. Quotes <br />submitted,by FAX shall be followed up by original mailed to the address on the Request For Quotation. <br />Contractor is required to furnish a current certificate of Worker's Compensation Coverage, certificate of <br />General Liability Insurance and certificate of Automobile Insurance prior to beginning the work <br />described. . <br />The undersigned hereby proposes to furnish all labor and material and to perform ail work as required by <br />the City of~Eugene Request For Quotation, dated Nov. 4, 2003, for the fixed sum of: <br />BASE NOT TO EXCEED QUOTE: S 2 ~ `142.00 <br />"TWO THOUSAND FOUR HLIDTDRED FORTY TWO AND NO/ZmOs Dottars. <br />COMPANY INFORMATION <br />Submit with the quotation descriptive and information describing the company and key staff to be <br />performing the work, and references with contact information. List BOLI wage categories to be used. <br />TIIKE OF COMPLETION <br />The undersigned agrees, if awarded Contract, to fully complete the Work prior to the cut-over as possible <br />and during the time of the cut-over. <br />ADDENDA <br />The undersigned acknowledges receipt of and agrees to be bound by addenda numbered O through <br />,Q~inclusive. <br />BIDDER'S STATEMENT <br />The undersigned, by submitting a Quote, represents that: . <br />A. The Bidder has visited the site, become familiar with the extent and local conditions under which <br />the Work is to be performed and has correlated the Bidder's personal observations with the <br />requirements of the Request for Quotations. <br />B. The Quote is based upon the experience, certification, materials, equipment, and systems required <br />by the Request for Quotations without exception. <br />C. The undersigned certifies that the Quote has been arrived at independently and has been submitted <br />without any collusion designed to limit independent bidding or competition. <br />D. The undersigned certifies to comply with provisions of ORS 279.350. <br />E. The undersigned certifies to have in-place a Qualifying Employee Drug Testing Program, pursuant <br />to ORS 279.312. <br />