Maintenance and Repairs of Fuel Dispensers and Automated Network Services

EXHIBIT I

OFFICIAL SIGNATURE PAGE

The bidder warrants that no person or selling agency has been employed or retained to solicit or secure this contract upon agreement or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees. For breach or violation of this warranty, the City shall have the right to annul this agreement without liability or, at its discretion, to deduct from the contract prices or consideration, or otherwise recover the full amount of such commission, percentage, brokerage, or contingent fee.

The undersigned hereby offers to furnish and deliver the goods and/or services as specified at the prices and terms herein stated and in accordance with the Invitation to Bid, Clarification Letters, and General Terms & Conditions, all of which are made a part of this offer.

All pages of the City of Houston's solicitation, including but not limited to the General Terms & Conditions, are incorporated by reference into for all purposes.

The undersigned, as bidder, certifies that the only person or parties interested in this proposal as principals are those named herein; that the bidder has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the award of this Contract.

NOTE: BID MUST BE SIGNED BY AN AUTHORIZED REPRESENTATIVE OF THE BIDDER, WHICH MUST BE THE ACTUAL LEGAL ENTITY THAT WILL PERFORM THE CONTRACT IF AWARDED.

Respectfully Submitted:

_______________________________________________________________________________________

(Print or Type Name of Bidder - Full Company Name)

City of Houston ERP ID (If already doing business with City): __________________________________________

Federal Identification Number: _____________________________________________________________________

By: ____________________________________________________________________________________

(Signature of Authorized Officer or Agent)

Printed Name: ___________________________________________________________________________

Title: ___________________________________________________________________________

Date: ___________________________________________________________________________

Address of Bidder: _____________________________________________________________________

Street Address or P.O. Box

_____________________________________________________________________

City - State - Zip Code

Email Address of Bidder: ___________________________________________________________

Telephone No. of Bidder: (_____) __________________________________________________________

EXHIBIT I

REFERENCES

LIST OF PREVIOUS CUSTOMERS

1. Name: ___________________________________ Phone No.: _________________

Address: __________________________________________________________________

Contract Award Date: ________________ Contract Completion Date: _______________

Contract Name/Title: ________________________________________________________

Email: ________________________________________________________

Project Description: _________________________________________________________

__________________________________________________________________________

2. Name: ___________________________________ Phone No.: _________________

Address: __________________________________________________________________

Contract Award Date: ________________ Contract Completion Date: _______________

Contract Name/Title: ________________________________________________________

Email: ________________________________________________________

Project Description: _________________________________________________________

__________________________________________________________________________

3. Name: ___________________________________ Phone No.: _________________

Address: __________________________________________________________________

Contract Award Date: ________________ Contract Completion Date: _______________

Contract Name/Title: ________________________________________________________

Email: ________________________________________________________

Project Description: _________________________________________________________

__________________________________________________________________________

4. Name: ___________________________________ Phone No.: _________________

Address: __________________________________________________________________

Contract Award Date: ________________ Contract Completion Date: _______________

Contract Name/Title: ________________________________________________________

Email: ________________________________________________________

Project Description: _________________________________________________________

EXHIBIT I

LIST OF SUBCONTRACTOR(S)

The following is a list of Subcontractors we propose to engage on the following items of Work. Any item of Work which does not designate a Subcontractor will be done by the firm submitting the Proposal.

SEGREGATED PART OF WORK SUBCONTRACTOR/SUPPLIER

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________

________________________________ __________________________________