| Location: | New York |
|---|---|
| Posted: | Jul 30, 2026 |
| Due: | Aug 25, 2026 |
| Agency: | City of Saratoga Springs |
| Type of Government: | State & Local |
| Category: |
|
| Solicitation No: | RFP 2026-16 |
| Publication URL: | To access bid details, please log in. |
| Bid Number: |
RFP 2026-16
|
| Bid Title: |
Integrated Pest Management Services
|
| Category: | Bids and RFPs |
| Status: | Open |
|
| Integrated Pest Management |
|---|
| Services |
JOHN SAFFORD
MAYOR
JOANNE KIERNAN
COMMISSIONER OF FINANCE
BK KERAMATI
COMMISSIONER OF PUBLIC WORKS
TIM COLL
COMMISSIONER OF PUBLIC SAFETY
JESSICA TROISI
COMMISSIONER OF ACCOUNTS
City of Saratoga Springs, NY
Request for Proposal
Integrated Pest Management
Services
PREPARED BY: Department of Public Works
July 29, 2026
.........................................................................................................................................................
ALL BIDS SHALL BE ENCLOSED IN A SEALED ENVELOPE MARKED:
RFP #: 2026-16 - Integrated Pest Management Services
Name of Bidder: ____________________________________
RFP Opening: Tuesday, August 25th, 2025 at 2:00 p.m.
AND RETURN TO:
City of Saratoga Springs
Department of Accounts
474 Broadway Suite 14
Saratoga Springs, NY 12866
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
NOTICE TO BIDDERS
The City of Saratoga Springs, New York, will receive sealed bids for Integrated Pest Management Services.
Sealed bids must be received in its' entirety by the City of Saratoga Springs, Office of the Commissioner of
Accounts, 474 Broadway Suite 14, Saratoga Springs, New York, 12866, by Tuesday August 25, 2026 at 2:00 p.m.
at which time they will be publicly opened and read.
Copies of the Request for Proposal (RFP) may be obtained on the City's web page at www.saratoga-springs.org,
under current bids. There is no fee for these documents.
Addenda, if any, will be issued only to those persons whose name and address are on record with the City as
having obtained a bid packet. Addenda to the bid, when issued, will be on file in the City Clerk's Office at least five
(5) days before the bid opening date. If you have obtained a bid packet through the City's web site and would like
to be on record for any Addenda please email stefanie.richards@saratogaspringsny.gov with your name, the name
of the bid packet obtained and email address.
Questions regarding the bid should be directed to Stefanie Richards in writing at
stefanie.richards@saratogaspringsny.gov. All bids must be made on the official bid form or an exact copy by
reproduction thereof and enclosed is a sealed envelope.
No Bidder may withdraw his/her bid within sixty (60) calendar days after the actual date of the opening thereof. A
Bidder may withdraw their bid response in writing immediately following this sixty (60) day per New York State
Finance Law 163(9)(e). The City reserves the right to reject any and all bids, to waive any and all informalities
and the right to disregard all nonconforming, non-responsive or conditional bid documents per New York State
Finance Law 163(9)(d).
INSTRUCTIONS TO BIDDERS
1. RFP DOCUMENTS
This document includes a complete set of the RFP specifications and required documents, which are for the
convenience of Bidders and are not to be detached from the bid. Failure to submit the required forms at the
time of bid submission may disqualify the bid submission.
2. INTERPRETATION OR ADDENDA
No oral interpretation will be made to any Bidder as to the meaning of the bid or any part thereof. Every
request for such an interpretation shall be made in writing to the City. Any inquiry received seven (7) or more
days prior to the date fixed for opening of bids shall be given consideration. Every interpretation made to a
Bidder shall be in the form of Addenda to the bid, and when issued, shall be on file in the City Clerk's Office at
least five (5) days before bids are opened. All Addenda shall be emailed to each person whose name and
address are on record with the City as having obtained a bid packet or has attended a pre-bid meeting. All such
Addenda shall become part of the bid and all Bidders shall be bound by such Addenda, whether or not received
by the Bidders.
3. BIDS
All bids shall be submitted on documents supplied by the City and shall be subject to all requirements of the
bid, including any plans, and these Instructions to Bidders. All bids shall be regular in every respect and no
interlineations, excisions or special conditions shall be made or included in the bid documents by the Bidder.
The City may consider as irregular any bid on which there is an alteration of or departure from the bid forms
hereto attached and at its' option may reject the same. Purchases by the City of Saratoga Springs are not
subject to any sales or federal excise taxes.
4. NON-COLLUSIVE BIDDING AND VENDOR CERTIFICATIONS:
Each Bidder submitting a bid to the City for the work contemplated by the documents on which bidding is based
shall execute and attach thereto, the Non-Collusion and Vendor Code of Conduct Affidavit on the form
Page 2 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
herein provided, to the effect that he/she has not colluded with any other person, firm or corporation in regard to
any bid submitted.
5. RISK AND SAFETY AGREEMENT AND CERTIFICATE OF INSURANCE:
Bidder must execute the Risk and Safety Agreement and include the agreement with the bid response
submission. A Certificate of Insurance providing proof of the required insurance as outlined in the Risk and
Safety Agreement with the bid response submission
6. APPRENTICESHIP PROGRAM:
The City of Saratoga Springs hereby requires any contractor on a project in excess of Two Hundred Thousand
Dollar ($200,000.00) aggregate, at the time of bid date, or submission of quote, and prior to entering into a
construction contract with the City of Saratoga Springs, or any sub-contractor on such a project with a sub-
contract in excess of Fifty Thousand Dollar ($50,000.00) aggregate, at the time of bid date, or submission of
quote, and prior to entering into a sub-contract with a contractor who has a construction contract with the city of
Saratoga Springs on a project in excess of Two Hundred Thousand Dollar ($200,000.00)aggregate, to have
apprenticeship agreements traditionally and historically appropriate for the type and scope of work to be
performed, which have been registered with, and approved by, the New York State Commissioner of Labor, and
which have a graduation rate of at least thirty percent (30%).
7. CORRECTIONS:
The Bidder must initial erasures or other changes in the bid.
8. RECEIVING BIDS:
Bids received prior to the advertised time of opening shall be securely kept, sealed. The City Clerk's office,
whose duty it is to open them shall decide when the specified time has arrived to open bids, and no bid
received thereafter will be considered. LATE BIDS shall be rejected. E-mail or faxed bid submissions are
not acceptable and shall not be considered.
9. OPENING OF BIDS:
At the time and place fixed for the opening of bids, the City shall cause to be opened and publicly read aloud
every bid that was received within the time set for receiving bids. Bidders and other persons properly
interested may be present, in person or by representative.
10. WITHDRAWAL OF BIDS:
Bids may be withdrawn on written request dispatched by the Bidder in time for delivery in the normal course of
business prior to the time fixed for opening; provided that written confirmation of withdrawal over the signature
of the Bidder is placed in the mail and postmarked prior to the time set for bid opening.
11. EVALUATION PROCESS:
After the bid opening, each Bidder's proposal will be screened for completeness and conformance with the
requirements for this bid submission as set forth under the Bidders Submittal Instructions. Written bid
amounts are the legally binding bid amount. Numeric bid amounts are viewed as a convenience. Proposals that
do not meet the City's requirements, as outlined in the RFP, may be deemed nonresponsive and given no
further consideration. Proposals meeting the City's requirements shall be evaluated first on technical
information (i.e. operational plan, company background, staffing and personnel biographies, relevant
experience, references) and then on the cost proposal.
Page 3 of 13
| The City, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 USC |
|---|
| 2000d to 2000d-4) and its regulations, hereby notifies all Bidders that it will affirmatively ensure that any |
| contract entered into pursuant to this advertisement will provide the opportunity for disadvantaged business |
| enterprises to be afforded full and fair opportunity to submit bids in response to this invitation and will not be |
| discriminated against on the grounds of race, color, or national origin in consideration for an award. |
| 16. SEXUAL HARRASSMENT: | |
|---|---|
| Every employer in the New York State is required to adopt a sexual harassment prevention policy giving all | |
| employees a legal right to a workplace free from sexual harassment. The City is committed to maintaining a | |
| workplace free from sexual harassment. Per New York State law, the City has a sexual harassment prevention | |
| policy in place. This policy applies to all employees, paid or unpaid interns and non-employees in our | |
| workplace, regardless of immigration status. |
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
12. AWARD OF CONTRACT: REJECTION OF BIDS
If the contract is awarded, it shall be awarded to the responsive and responsible Bidder submitting the best
value bid complying with the conditions and qualifications of the Notice to Bidders and Instructions to Bidders.
The Bidder to whom the award is made will receive a "Notice of Award" at the earliest possible date.
The City, however, reserves the right to:
a. reject any and all bids and to waive any informality in bids received whenever bid packages are submitted
incomplete without the required attachments and/or such rejections or waivers are in the City's best
interest;
b. consider as not responsible any Bidders who does not habitually perform with their own forces at least fifty
percent (50%) of the dollar value of the work involved in the contract;
c. award the bid, in part, on the Bidder's ability to provide timely technical assistance, part(s) replacement and
service for repairs;
d. give preference to Minority Women Business Enterprise (MWBE) businesses; and/or
e. extend the contract for one (1) year from expiration under the same terms and conditions as long as the
extension is agreeable to both the City and the Contractor.
13. EQUAL EMPLOYMENT OPPORTUNITY:
The City, state and federal government have stringent requirements for ensuring that all Bidders comply with
regulations requiring that employees and applicants for employment are not discriminated against because of
their race, color, religion, sex or national origin. Bidders will be required to abide by those requirements.
14. AMERICANS WITH DISBILITY ACT:
The Bidder agrees to comply with the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation
Act of 1973 and not discriminate on the basis of disability in the admission or access to, or treatment of
employment in its services, programs, or activities. The Bidder agrees to hold harmless and indemnify the City
from costs, including but not limited to damages, attorney's fees and staff time, in any action or proceeding
brought alleging a violation of ADA and/or Section 504 caused by the Bidder. The Bidder agrees that
accommodations will be provided upon request to allow individuals with disabilities to participate in all services,
programs and activities provided by the Bidder.
15. CIVIL RIGHTS:
The City, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 USC
2000d to 2000d-4) and its regulations, hereby notifies all Bidders that it will affirmatively ensure that any
contract entered into pursuant to this advertisement will provide the opportunity for disadvantaged business
enterprises to be afforded full and fair opportunity to submit bids in response to this invitation and will not be
discriminated against on the grounds of race, color, or national origin in consideration for an award.
16. SEXUAL HARRASSMENT:
Every employer in the New York State is required to adopt a sexual harassment prevention policy giving all
employees a legal right to a workplace free from sexual harassment. The City is committed to maintaining a
workplace free from sexual harassment. Per New York State law, the City has a sexual harassment prevention
policy in place. This policy applies to all employees, paid or unpaid interns and non-employees in our
workplace, regardless of immigration status.
17. COMPLIANCE
Failure to comply with any of the above terms or any evidence of poor quality or service will be considered
cause of discontinuing business with the successful Bidder.
Page 4 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
BIDDING SUBMITTAL INSTRUCTIONS
Failure to submit RFP documents as required may lead to an immediate disqualification.
In order to guard against premature opening of the bid documents, your bids must be
returned and enclosed in a sealed and clearly labeled envelope as follows:
Step One: You MUST execute and include the following documents, one original and one
copy of each, with your response:
Your response to the RFP in question (one original and one thumb drive)
Non-Collusive Bidding and Vendor Code of Conduct Certification
Risk & Safety Agreement and Certificate of Insurance
Step Two: Enclose your bid in a sealed envelope marked:
RFP #: 2026-16 - Integrated Pest Management Services
Name of Bidder: ____________________________________
Bid Opening: Tuesday, August 25th, 2026 at 2:00 p.m.
Step Three: Please return your response to this RFP to the following address:
City of Saratoga Springs
Department of Accounts
474 Broadway Suite 14
Saratoga Springs, NY 12866
Page 5 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
STATEMENT OF SPECIFICATIONS: Integrated Pest Management Services
The specification herein states the minimum requirements of the City. All bids must be regular in every respect.
Unauthorized conditions, limitations, or provisions shall be cause for rejection. The City may consider as "irregular"
or "non-responsive" any bid not prepared and submitted in accordance with the bid document and specification, or
any bid lacking sufficient technical literature to enable the City to make a reasonable determination of compliance to
the specification.
It shall be the Bidder's responsibility to carefully examine each item of the specification. Failure to offer a
completed bid or failure to respond to each section of the technical specification may cause the proposal to be
rejected without review as "non-responsive". All variances, exceptions and/or deviations shall be fully described in
the appropriate section.
It is the intention of the City of Saratoga Springs Department of Public Works to secure bids for Pest Management
Services for various City owned buildings throughout the City of Saratoga Springs. In comparing proposals,
consideration will not be confined to price only. The successful bid will be one whose services best meets the
interests of the City when standardization, price, product, quality and delivery are considered. The City reserves the
right to reject any or all bids or any part thereof, and to waive any minor technicalities. A contract will be awarded to
the Contractor submitting the lowest responsible bid meeting the requirements of this request.
This request is for Pest Management Services for various City owned buildings throughout the City of Saratoga
Springs. The goal is to deliver effective pest control while at the same time reducing the volume and toxicity of
pesticides used and human and environmental exposure to pesticides.
The Contractor shall furnish all supervision, labor, materials and equipment necessary to implement the necessary
intervention aspect for the surveillance, trapping and pesticide application component. The Contractor shall be
responsible for providing Material Safety Data Sheets for all pesticides utilized in City facilities.
Pests Included
The Contractor shall adequately suppress indoor populations of rats, mice, ants, winged termite swarmers
emerging indoors, incidental/occasional invaders entering from out-of-doors, cockroaches, flies, ground beetles,
bees, bed bugs, wasps, millipedes, centipedes, spiders, sow bugs, pill bugs, clover mites and any other arthropod
pests not specifically excluded from the contract.
The following pests will be considered special services, separate from the bid: birds, bats, snakes, termites,
mosquitoes, fleas, ticks and wild life trapping.
Special Services for Preventive Pigeon Solutions as needed:
The contractor shall provide preventive measures to deter pigeons from roosting or nesting on the facility's
structures. Services may include but are not limited to the installation of physical barriers (e.g., bird spikes, netting,
wire systems), visual deterrents, and low-voltage track systems. Work should be tailored to each building's design
to ensure minimal aesthetic impact and long-term effectiveness.
Special Services for Pigeon Control as needed:
The contractor shall implement active pigeon control methods to address existing infestations. This includes site
assessment, humane trapping, nest and waste removal, and cleanup of affected areas. Treatment may also involve
short-term deterrents and exclusion techniques to prevent re-entry, in compliance with local wildlife regulations.
Initial Inspection
The contractor shall conduct a thorough initial inspection of the City owned structures as described below. Problem
areas and any equipment structural features or management practices that are contributing to pest infestations will
be identified. The initial inspection shall be conducted by a certified commercial supervisory applicator.
Page 6 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
Buildings
City Hall: City Hall is located at 474 Broadway, Saratoga Springs. The building was constructed more than 100
years ago. The entire building is approximately 53,000 square feet. The inspections/work performed within the
Department of Public Safety Office and the Police Department are to be invoiced separately to the Department of
Public Safety.
Canfield Casino: The Canfield Casino is located in Congress Park, Saratoga Springs. The building was
constructed more than 100 years ago. It is approximately 10,000 square feet.
High Rock Park Bathroom: This is a small bathroom structure located in High Rock Park, near the Farmer's Market
Pavillon. This structure is only used during the summer months, therefore, inspections will be required only during
the summer months.
Weibel Avenue Ice Rink: The Weibel Ice Rink Facility structure is located on Weibel Avenue. The inspections will
be required in the locker rooms, bathrooms and main entrance area - including concession area.
Vernon Ice Rink: The Vernon Ice Rink Facility structure is also located on Weibel Avenue. Services will be required
in the locker rooms, bathrooms and main entrance area.
Indoor Recreation Facility: The Indoor Recreation Facility is located on Vanderbilt Avenue.
DPW Dispatch Office: The DPW Dispatch Office is located at 29 VanRensselaer Street. Only the Dispatch Office is
to be inspected at this location.
Lake Avenue Fire Station: This structure is located at 60 Lake Avenue. The entire building is to be inspected --
approximately 21,600 square feet. The inspections/work performed within the Lake Avenue Fire Station shall be
invoiced separately to the Department of Public Safety.
West Avenue Fire Station: This structure is located at 166 West Avenue. The entire building is to be inspected --
approximately 11,668 square feet. The inspections/work performed within the West Avenue Fire Station shall be
invoiced separately to the Department of Public Safety.
Henning Road Fire Station, located at 16 Henning Road, Saratoga Springs, NY 12866. The inspections/work
performed within the West Avenue Fire Station shall be invoiced separately to the Department of Public Safety.
Pest Control Plan
Prior to the initiation of service, the Contractor shall submit to the Commissioner of Public Works a Pest Control
Management Plan for the building as follows:
1. Proposed methods for control, including labels and Material Safety Data Sheets for all pesticides to be used.
2. A service schedule, broken down by building.
3. Description of any structural or operational changes that would facilitate the pest control efforts.
4. Copy of the Commercial Pesticide Applicator Certificate for every Contractor's representative who will perform
on-site service.
5. Proposed equipment for access, i.e., lifts, ladders, etc.
The Contractor shall perform routine pest control services that do not adversely affect occupant health. No sprays
or dusts may be applied when the immediate area to be treated is occupied. The Contractor shall not apply any
pesticide product that has not been included in the Pest Control Plan or approved in writing by the Commissioner of
Public Works.
Pesticide application shall be according to need and not by schedule. Preventative pesticide treatment of areas
determined to be at high risk for infestation by insects or rodents, through inspection at the onset of the program or
as part of a maintenance program, are acceptable.
Page 7 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
When it is necessary to perform work outside of the regularly scheduled hours set forth in the Pest Control Plan, the
Contractor shall notify the Public Works/Public Safety Offices at least one day in advance.
Monthly Inspection
The Contractor will conduct monthly routine visual inspections of pest prone areas for signs of active pest
infestations and for conditions that are conducive to attracting or harboring pests. If treatment is required for any
included pests, the technician shall treat the infested area(s), outside of regular work hours if needed.
Special Requests & Emergency Services
On occasion, the Department of Public Works may request that the Contractor perform corrective, special or
emergency services that are beyond the routine service requests. The Contractor shall respond to these
exceptional circumstances and complete the necessary work within one working day after receipt of the request.
Should the Contractor determine that special or emergency services that are beyond the routine service requests
are necessary, the Contractor will contact the Department of Public Works immediately to determine a plan of
action and cost estimates.
Prevailing Wage Rate
The Contractor shall follow Prevailing Wage Rates.
Documentation
The Contractor shall be responsible for maintaining a pest control logbook or file and these records shall be kept on
site at each building. The Contractor will maintain the records on each visit. The logbook shall contain at least the
following:
1. A copy of the pest control plan and MSDS sheets.
2. The pest control work and Inspection Report forms. Upon completion of a service visit to the building, the
Contractor's representative performing the service shall complete, sign and date the form and return it to the
logbook.
Definition of Regular and Overtime Hours
Regular Business hours are defined as any hours worked between 7:00 a.m. and 5:00 p.m. Monday through
Friday. Overtime hours are defined as any work performed outside of Regular Business work hours; which may
include holidays. The labor rate shall include all travel. No additional travel time or mileage will be honored.
Time and Material Work
All bids for Special Requests and Emergency Services shall include a cost breakdown submitted by the Contractor
as follows: labor rate, quantity of hours and materials list. Each Special Request and Emergency Service shall
generate a separate invoice detailing labor charge and parts/materials as outlined.
Unsatisfactory Performance
The City may consider the following performance by the successful Contractor as unsatisfactory performance:
1. In excess of one service "call back" to correct the same problem with 30 consecutive calendar days.
2. In excess of one instance with one calendar year of successful bidder personnel assigned to unauthorized
service call not having the skill or knowledge to diagnose the problem and/or perform the repair.
Performance Warranty
The Contractor shall guarantee all work against any defects in workmanship and shall satisfactorily correct, at no
cost to the City, any such defect that may become apparent within a period of one year after completion of work.
The Contractor shall leave the work are broom-clean of materials, debris, and equipment and shall dispose of all
defective materials removed in performance of the service and within strict accordance with all applicable rules,
regulations, codes, laws, ordinance, statutes, etc.
The Contractor shall clean, repair or replace any item damaged by the successful bidder during the performance of
the service at no additional cost to the City.
Page 8 of 13
| Location | Monthly Inspection Fee | Annual Fee (12 months) |
|---|---|---|
| City Hall, 474 Broadway (except Police Department and Public Safety on ground floor) | $ | $ |
| Canfield Casino, Congress Park | $ | $ |
| High Rock Park, public bathroom | $ | $ |
| Weibel Avenue Ice Rink | $ | $ |
| Indoor Recreation Facility | $ | $ |
| DPW Dispatch Office | $ | $ |
| City Hall, 5 Lake Ave (Police Department and Public Safety on ground floor) | $ | $ |
| Lake Avenue Fire Station | $ | $ |
| West Avenue Fire Station | $ | $ |
| Henning Road Fire Station | $ | $ |
| TOTAL | $ |
| EMERGENCY AFTER-HOURS | Service Rate per Call out | Total Emergency Services (Estimated*) |
|---|---|---|
| Estimated Annual Emergency Events: 6 (six) across all locations. | $ | $ |
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
Invoicing
An invoice will be generated after each service has been performed. Each service call or additional work request
shall generate a separate invoice detailing the labor charge, parts and materials. Each invoice shall have attached
a final service report referencing all service activity per work order and/or monthly report.
PROPOSAL:
Table 1
Location Monthly Inspection Annual Fee (12
Fee months)
City Hall, 474 Broadway (except Police Department
$ $
and Public Safety on ground floor)
Canfield Casino, Congress Park $ $
High Rock Park, public bathroom $ $
Weibel Avenue Ice Rink $ $
Indoor Recreation Facility $ $
DPW Dispatch Office $ $
City Hall, 5 Lake Ave (Police Department and Public
$ $
Safety on ground floor)
Lake Avenue Fire Station $ $
West Avenue Fire Station $ $
Henning Road Fire Station $ $
TOTAL $
Table 2
EMERGENCY AFTER-HOURS Service Rate per Call Total Emergency
out Services
(Estimated*)
Estimated Annual Emergency Events: 6 (six) across all $ $
locations.
*The number of call outs are estimated and not guaranteed.
To calculate total bid in figures, add the Total Annual Fee inspection fees from Table 1 plus Total Emergency
Services from Table 2.
TOTAL BID IN FIGURES: $
TOTAL BID WRITTEN:
COMPANY NAME:
ADDRESS:
Phone No. ( ) -
(City) (State) (Zip)
Page 9 of 13
City of Saratoga Springs, NY RFP Opening: Tuesday August 25th 2026 2:00 p.m.
Integrated Pest Management Services: RFP # 2026-16
_____________________________________________________________________________________________________________________
E-MAIL ADDRESS:
AUTHORIZED SIGNATURE:
PRINTED NAME:
TITLE: DATE:
Page 10 of 13

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