This form contains 9 fields organized into 4 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
General
Authorized Signature Signature
Reviewed Sample County Contract (Question 1)
Question 1 - Yes Radiobutton
Check this box if you have reviewed the Sample County Contract and Special Terms and Conditions exhibits on behalf of your agency.
Question 1 - No Radiobutton
Check this box if you have not reviewed the Sample County Contract and Special Terms and Conditions exhibits on behalf of your agency.
SIGNATURE (Must be signed by an individual with the legal authority to enter into a contract with the County of Sonoma on behalf of the proposer)
Authorized Signature Text
Enter the signature of the individual who has legal authority to bind the proposer to a contract with the County of Sonoma.
Printed Name Text
Enter the full printed name of the person who signed in the Authorized Signature field.
Date Signed Date
Enter the date on which the authorized individual signed this document.
Willingness to Enter Contract and Proposed Changes (Questions 2-3)
Question 2 - Yes (Willing to enter into contract) Checkbox
Check this box if your agency would be willing to enter into a contract with the County of Sonoma under the terms outlined in the Sample County Contract and Special Terms and Conditions (including insurance requirements).
Question 2 - No (Not willing to enter into contract) Checkbox
Check this box if your agency would not be willing to enter into the County contract as written; if checked, you should identify any proposed contract term changes in Question 3.
Question 3 – Proposed Contract Changes Text
If you answered “No” to willingness to enter the contract, describe any specific terms in the Sample County Contract you would propose changing and explain how you would change them. Fill only if 'Question 2 - No (Not willing to enter into contract)' is 'Yes'.
Depends on: Question 2 - No (Not willing to enter into contract)