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Exhibit E <br /> Small Local Emerging Business(SLEB)Program new Certification Application <br /> REP No.900973 for Operation and Maintenance Services of Sewer and Water Systems in the Alameda <br /> County Service Area(CSA)R-1967-1 Castlewood <br /> East Bay Interagency Alliance ( EBIA) <br /> COMMON APPLICATION for <br /> LOCAL CERTIFICATION <br /> Alameda County--Alameda County Transportation Commission—City of Oakland—Port of Oakland <br /> Submittal Date: _ <br /> Check Certifying Agency and click link to download Supplemental: <br /> n Alameda County—No supplemental required <br /> ❑ Alameda County Transportation Commission —Complete Supplemental 13 <br /> ❑ City of Oakland—Complete Supplemental C <br /> ❑ Port of Oakland—Complete Supplemental I) <br /> n All the above <br /> The Common Application is a sharing of information between agencies and NOT a reciprocal certification. <br /> 1) Contact Information <br /> Legal Name of Entity Contact Person(Name&Title) <br /> Street Address of Entity(No P.O.Box) <br /> City State Zip Code County <br /> Telephone Fax# Cell# <br /> ( ) ( ) <br /> Email Address Web Site <br /> 2) Company Profile <br /> Primary Service undertaken/offered: Specialty Service undertaken/offered: <br /> Date Entity was established(tnnJdd/yr) Does the entity have one or more additional offices outside Date Oakland office was established <br /> the city of Oakland.CA? DY ❑N (mnddd/yr) <br /> If yes.list other location(s) <br /> Method of Acquisition ['New ['Purchased existing ❑Secured concession Federal ID Number: <br /> ❑Merger or consolidation ❑Inherited ❑Other(explain) <br /> Has this entity operated under a different name during the past live years? <br /> Type of Firm Ethnicity Group of owners(s)that own greater than 50%of the <br /> ❑Sole Proprietorship business. (for tracking purposes only) <br /> ❑Joint Venture ❑African American ❑ I Iispanic <br /> ❑Partnership ❑Asian ❑Native American <br /> ❑Corporation ['Asian Pacific/Hawaiian ❑Multi ethnic ownership <br /> ❑Limited Liability Partnership ['Asian Indian <br /> ['Multi ethnic minority <br /> ❑Limited Liability Corporation ❑Caucasian ownership <br /> ❑Publicly traded entity ❑Filipino ❑Other <br /> ❑Non-Profit(Sr Church <br /> ❑(hher Gender(for trucking purposes only) <br /> Male Female <br /> Gross Receipts for the last three recent fiscal <br /> years: Year Ended Total Receipts$ <br /> Please attach copies of appropriate tax Year Ended _- "Fool Receipts$ - <br /> returns:(e.g.Finn 990.Form 1040.Form Year Ended Total Receipts S_ <br /> 1 120,etc) <br /> Page I of 2 <br />