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DocuSign Envelope ID: C327FODO-D8DF-4343-B5DB-90853D1ED8AA <br />Exhibit A - RFP E-03-22 <br />COMPLETE THE PROPOSER INFORMATION FORM ON THE ATTACHMENTS TAB IN THE <br />EBID SYSTEM. PROPOSERS ARE TO COMPLETE FORM IN ITS ENTIRITY AND INCLUDE <br />THE FORM IN YOUR PROPOSAL THAT MUST BE UPLOADED TO THE RESPONSE <br />ATTACHMENTS TAB FOR THE RFP IN THE EBID SYSTEM. <br />PROPOSER INFORMATION PAGE <br />RFP E-13-17 Unleaded Gasoline and Diesel Fuel for Southeast Florida Purchnsing Cooperative Group <br />(number) (RFP name) <br />To: The City of Pompano Beach, Florida <br />The below named company hereby agrees to furnish the proposed services under the terms <br />stated subject to all instructions, terms, conditions, specifications, addenda, legal advertisement, <br />and conditions contained in the RFP. I have read the RFP and all attachments, including the <br />specifications, and fully understand what is required. By submitting this proposal, I will accept a <br />contract if approved by the City and such acceptance covers all terms, conditions, and <br />specifications of this proposal. <br />Proposal submitted by: <br />Name (printed) Don Carlton <br />Title President <br />Company (Legal Registered) Port Consolidated <br />Federal Tax Identification Number 59'1173292 <br />address 3141 Se 14th Ave. <br />City/State/Zip Fort Lauderdale, FL 33316 <br />Telephone No. 800-683-5823 <br />Fax No. 954-527-1191 <br />Email Addressdcariton@portconsolidated.com <br />