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0 <br />City of Santa Ana <br />ITEM 1: COVER LETTER <br />(4 PAGE LIMIT) <br />Please include a cover letter, on official Proposer letterhead, that describes the Proposer <br />and its qualifications. <br />A. The official name of the Proposer; <br />B. The Proposer's organizational structure (e.g. corporation, partnership, limited <br />liability corporation, or otherwise); <br />C. The jurisdiction in which the Proposer is organized and the date of such <br />organization; <br />D. The address and telephone number of the Proposer's headquarters and of any <br />local office involved in the bid proposal; <br />E. The Proposer's Federal Tax Identification Number; <br />F. The name, address, telephone, fax numbers and e-mail address of the <br />person(s) who will serve as the authorized contact(s) to the City of Santa Ana <br />and OCFA with regards to the bid proposal, the RFP process, the Contract <br />Documents, and the administration of the contract, if awarded, with <br />authorization to make representations on behalf of and to bind the Proposer; <br />G. Provide applicable authorized signature documentation, pursuant to Proposer's <br />organizational structure/bylaws, verifying the authority of the person signing the <br />original bid proposal to commit to the proposal on behalf of the Proposer (attach <br />to cover letter); <br />H. A representation that the Proposer is in good standing in the State of California <br />and has obtained all necessary licenses, permits, certifications, approvals and <br />governmental authorizations necessary in order to perform all of the required <br />performance obligations specified in the RFP; <br />A representation that the Proposer is in good standing in the Medicare and <br />Medi -Cal programs and is not the subject of any pending actions, investigations <br />or prosecutions, whether civil, criminal or administrative, relating to their billing <br />or reimbursement practices, and that Proposer has not been excluded from any <br />state or federal healthcare program or employs any individual who has been <br />excluded from any state or federal healthcare program; <br />City of Santa Ana Page 167 <br />Fire/EMS Emergency Ambulance Transportation and Related Services <br />Request for Proposals: # 18-059 <br />August 28, 2018 <br />19D-77 <br />