Common use of SIGNATURE PAGE Clause in Contracts

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named Insured: Specification #: Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> TBD Specification Number: <<click and type number>> Contractor 476491 Consultant (Vendor) Name: <<click and type name>> TBD Total Amount (Value): <<click and type number>> TBD Fund Chargeable: <<click 017-0100-099-0994425-0140-220140 and type number>> various SIGNED at Chicago, Illinois: CONTRACTORCONSULTANT: <<click and type name>> TBD By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. EXHIBIT 1: SCOPE OF SERVICES AND KEY PERSONNEL EXHIBIT 2: SCHEDULE OF COMPENSATION EXHIBIT 3: INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: 476491 Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors Consultants [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Consultants Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named InsuredExhibit 1: Detailed Scope of Services Exhibit 1, Attachment A: Key Personnel Specification #132849 EXHIBIT 2: AddressCOMPENSATION Compensation Schedule: RFP: (Number Time and Street) Project #: Contract #: (City) (State) (ZIP) Description Material Only The Contractor named below proposes to provide all Services described in the Scope of Operation/Location The insurance policies and endorsements indicated below have been issued to Services for the designated named insured with the policy limits as fees set forth herein covering the operation described within the contract involving the named insured below. COMPANY NAME: Key Personnel (Title) Maximum fully- loaded hourly rates 2013* Maximum fully- loaded hourly rates 2014* Maximum fully- loaded hourly rates 2015* Maximum fully- loaded hourly rates 2016* Maximum fully- loaded hourly rates 2017* Maximum fully- loaded hourly rates 2018* Maximum fully- loaded hourly rates 2019* *Fully Loaded Hourly Rates include, but are not necessarily limited to: labor, overhead and the City payroll burden. Exhibit 2: Schedule of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60Compensation 87 Specification #132849 Exhibit 3: Certificate(s) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits Specification #132849 Exhibit 4: MBE/WBE Compliance Plan  Schedule B: Affidavit of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] ExplosionJoint Venture (if applicable)  Schedule C-3: Letter of Intent From MBE/Collapse Underground [ ] ProductsWBE To Perform As Subcontractor, Supplier and/or Consultant  Schedule D-3: Compliance Plan Regarding MBE/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $WBE Utilization

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named InsuredExhibit 1: Specification #Detailed Scope of Services Exhibit 1, Attachment A: AddressKey Personnel EXHIBIT 2: RFPCOMPENSATION Compensation Schedule: (Number Time and Street) Project #: Contract #: (City) (State) (ZIP) Description Material Only The Contractor named below proposes to provide all Services described in the Scope of Operation/Location The insurance policies and endorsements indicated below have been issued to Services for the designated named insured with the policy limits as fees set forth herein covering the operation described within the contract involving the named insured below. COMPANY NAME: Key Personnel (Title) Maximum fully- loaded hourly rates 2013* Maximum fully- loaded hourly rates 2014* Maximum fully- loaded hourly rates 2015* Maximum fully- loaded hourly rates 2016* Maximum fully- loaded hourly rates 2017* Maximum fully- loaded hourly rates 2018* Maximum fully- loaded hourly rates 2019* *Fully Loaded Hourly Rates include, but are not necessarily limited to: labor, overhead and the City payroll burden. Exhibit 2: Schedule of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60Compensation 87 Exhibit 3: Certificate(s) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits Exhibit 4: MBE/WBE Compliance Plan • Schedule B: Affidavit of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] ExplosionJoint Venture (if applicable) • Schedule C-3: Letter of Intent From MBE/Collapse Underground [ ] ProductsWBE To Perform As Subcontractor, Supplier and/or Consultant • Schedule D-3: Compliance Plan Regarding MBE/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $WBE Utilization

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor 245659 Consultant (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTORCONSULTANT: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. EXHIBIT 1: DETAILED SCOPE OF SERVICES Exhibit 1, Attachment A: Key Personnel EXHIBIT 2: COMPENSATION EXHIBIT 3: INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: 245659 Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors Consultants [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Workers Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Consultants Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> 417551 Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named Insured: Specification #: 417551 Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click 47 LIST OF SCHEDULES Schedule I. Order for Billing and type number>> Specification Number: <<click Collection Services Schedule II. Billing and type number>> Contractor Collection Services Price List Schedule III. Start-Up Charge Schedule IV. Minimum Annual Purchase of Service LIST OF EXHIBITS Exhibit A Proprietary Information Exhbiit B Billing and Collection Services Requirements Document Exhibit C Billing and Collection Services Invoice Billing Requirements AGREEMENT FOR THE PROVISION OF BILLING AND COLLECTION SERVICES BETWEEN SOUTHWESTERN XXXX TELEPHONE COMPANY AND AXCES INC. ---------------------------------- (VendorCustomer NAME) Name: <<click This Agreement for the Provision of Billing and type name>> Total Amount Collection Services (Value): <<click hereinafter "Agreement") is entered into and type number>> Fund Chargeable: <<click effective this 21st day of November, 1997, between Southwestern Xxxx Telephone Company (hereinafter "SWBT") a Corporation in good standing, organized and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: existing under the laws of the State of ; County Missouri and having its principle place of This instrument was acknowledged before me on business in St. Louis, Missouri and AXCES INC. ----------------------------------- (dateCustomer's Name) by as President a CORPORATION ------------------------------------ (or other authorized officerCorporation, Partnership, Sole Proprietorship), in good standing, organized and existing under the laws of the State of TEXAS -------------------- (N/A if not a corporation) and as Secretary having its principle place of _ business in HOUSTON, TEXAS ----------------------------- (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named Insured: Specification #: Address: RFP: (Number City and Street) Project #: Contract #: (City) (State) (ZIP) Description If intrastate services are provided in the states of Operation/Location Kansas and/or Texas, this Agreement shall take effect, in Kansas, upon approval of this Agreement by the Kansas Corporation Commission, and in Texas, upon approval of this Agreement by the Texas Public Utility Commission. The insurance policies and endorsements indicated below have been issued to the designated named insured Customer shall request that SWBT file this Agreement with the policy limits applicable state regulatory jurisdictions for approval. It is understood by the parties that services may not be immediately initiated, but that any time, for matters such as set forth herein covering regulatory approval of the operation described Agreement and service start-up and testing, will be included within the contract involving term of this Agreement and that the named insured and effective date of this Agreement is not delayed or affected by the City timing of Chicagoactual provision of service, see: Schedule I (for term of service(s) ordered) attached hereto. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in In consideration of the contract entered into with Customer's agreement to make payment for services as described herein and of SWBT's willingness to provide said services as described herein during the named insuredterm of this Agreement, and it is mutually understood that the City of Chicago relies on this certificate parties agree as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $follows:

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named Insured: Specification #: Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor 245659 Consultant (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTORCONSULTANT: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. EXHIBIT 1: DETAILED SCOPE OF SERVICES Exhibit 1, Attachment A: Key Personnel EXHIBIT 2: COMPENSATION EXHIBIT 3: INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: 245659 Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors Consultants [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Workers Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Consultants Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. EXHIBIT 1: SCOPE OF WORK EXHIBIT 2: COMPENSATION Compensation Schedule: Time and Material Only The Contractor named below proposes to provide all Services described in the Scope of Services for the fees set forth below. COMPANY NAME: Key Personnel (Title) Maximum fully- loaded hourly rates 2013* Maximum fully- loaded hourly rates 2014* Maximum fully- loaded hourly rates 2015* Maximum fully- loaded hourly rates 2016* Maximum fully- loaded hourly rates 2017* Maximum fully- loaded hourly rates 2018* Maximum fully- loaded hourly rates 2019* *Fully Loaded Hourly Rates include, but are not necessarily limited to: labor, overhead and payroll burden. EXHIBIT 3: INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Workers Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $

SIGNATURE PAGE. Contract Number: <<click and type number>> Specification Number: <<click and type number>> 608176 Contractor (Vendor) Name: <<click and type name>> Total Amount (Value): <<click and type number>> Fund Chargeable: <<click and type number>> SIGNED at Chicago, Illinois: CONTRACTOR: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date Execution page 83 EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. Named InsuredEXHIBIT 4: Specification #ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT(S) Instructions: AddressComplete the online Economic Disclosure Statement (EDS) which includes a Disclosure of Retained Parties. Please submit an electronically signed, one page EDS Certificate of Filing which validates that the EDS has been filed. Additionally, the Municipal Code of Chicago requires the disclosure of Familial Relationships with Elected City Officials and Department Heads. The web address to submit your EDS and Familial Relationships Disclosure is: RFPxxxxx://xxxxxxx.xxxxxxxxxxxxx.xxx/EDSWeb EXHIBIT 5: (Number MBE / WBE COMPLIANCE PLAN EXHIBIT 6: COMPLIANCE WITH CDBG REGULATIONS/ADDITIONAL AGREEMENT PROVISIONS TERMS FOR CDBG FEDERALLY FUNDED PROFESSIONAL SERVICES The Contractor, and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued any subcontractors, shall at all times act in a manner that allows the City to the designated named insured maintain compliance with the policy limits HUD CDGB grant included as set forth herein covering the operation described within the contract involving the named insured Exhibit 7, as it currently exists and the City as it may be amended from time to time, which is incorporated by reference and made a part of Chicagothis Contract. The Certificate issuer agrees that in In the event of cancellation, non-renewal or material change involving a conflict between the indicated policiesrequirements of the grant and the provisions of this contract, the issuer will provide at least sixty (60) days prior written notice of such change grant shall control except to the City extent that this Contract may impose a more stringent requirement on Contractor. The following provisions apply to contracts funded with U.S. Department of Chicago at the address shown on this CertificateHousing ("HUD") Community Development Block Grant ("CDBG") funding, in whole or in part. This certificate If there is issued to the City of Chicago in consideration a conflict between these provisions and other terms and conditions of the contract entered into with the named insuredcontract, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Compensation and Employer=s Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Protective $ Other $these terms will control.

SIGNATURE PAGE. Contract Number: <<click and type number>> TBD Specification Number: <<click and type number>> Contractor 227631 Consultant (Vendor) Name: <<click and type name>> TBD Total Amount (Value): <<click and type number>> TBD Fund Chargeable: <<click 016-0355-023-2015-9805-22-0140 and type number>> various SIGNED at Chicago, Illinois: CONTRACTORCONSULTANT: <<click and type name>> By: Name: Its: Attest: State of ; County of This instrument was acknowledged before me on (date) by as President (or other authorized officer) and as Secretary of _ (name of party on behalf of whom instrument was executed). Notary Public Commission Expires CITY OF CHICAGO By: Mayor Date Comptroller Date Chief Procurement Officer Date EXHIBITS Exhibits follow this page. Remainder of page intentionally blank. EXHIBIT 1: SCOPE OF SERVICES EXHIBIT 2: SCHEDULE OF COMPENSATION EXHIBIT 3: INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: 227631 Address: RFP: (Number and Street) Project #: Contract #: (City) (State) (ZIP) Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors Consultants [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ General Aggregate $ Products/Completed Operations Aggregate $ Automobile Liability CSL Per Occurrence $ [ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ Worker=s Workers Compensation and Employer=s Employers Liability Statutory/Illinois Employers Liability $ Builders Risk/Course of Construction Amount of Contract Professional Liability $ Owner Contractors Consultants Protective $ Other $