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Category 2: Sensitive information <br />Page 16 of 23 Category 2: For official use only / disclosure permissible by law. <br /> <br />FORM 4.02 PRICE SHEET <br />REQUEST FOR PROPOSAL #2023-096 BIOXIDE® SUPPLY AND SERVICES <br />Supplier Name: <br />Prices must include providing all services as detailed in the Scope of Work. <br />1. Complete the price sheet. <br />2. Provide a firm fixed, not to exceed, lump sum amount for all services listed in Section 2. <br />3. Clearly identify any services mentioned in your response that are not included in your proposed fee such as <br />services that would be an additional expense. <br />A. Description Unit Price Quantity Extended Price <br />Bioxide® Supply & Services $ 100,000 Gallons $ <br />9.9% Sales Tax $ <br />Total $ <br /> <br /> <br />B. Optional Additional Services <br />Description Annual Rate <br />Per Site <br />Quantity Extended Price <br />Internet Based Monitoring System $ 4 each $ <br /> <br />