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Exhibit E Small Local Emerging Business(SLEB)Program new Certification Application RFP No.900973 for Operation and Maintenance Services of Sewer and Water Systems in the Alameda County Service Area(CSA)R-1967-1 Castlewood 2) Company Profile: (Continue) Number of Employees at the local office Seasonal Full Time _ Permanent Full time Temporary Full Time_ Seasonal Part Time Temporary Part Time Permanent Part time TOTAL Number of Employees at all locations. Temporary Full Time_ Seasonal Full Time Permanent Full time Temporary Part Time Seasonal Part Time Permanent Part time 3) Certifications: Name of Issuing Authority Type Number Ex Date on Date City/County Business Tax Certificate Internal Revenue Service(required)—If your firm is a Non-Profit,submit the Letter of Determination of Not For Profit Status. • State of CA/CUCP Certification for DBFJACDBE firm State of CA/SBA Certification for Small firm Other Certification Other Certification Other Certification 4) Professional Licenses, Permits and/or Certificates (e.g.contractor,architect,engineer.etc.—list all that apply-attach copies. List on a separate page if additional space is needed) Expiration Name of Issuing Authority Type Number Date State of CA Contractor's License Board—Contractor's License: State of CA Professional Service License or Permit: • State of CA Service Provider License or Permit: • Other: • Other: 5) NAICS Codes: Please review the NAICSI listing of work codes and indicate helow your areas of expertise tanked in order of importance (begin with primary and specialty areas as indicated in the Company Profile section)NAICS Codes can be found at: fit 1p://s Batt waics.condsruchhim&httn://ww accnsus.c(10cpcd/n:dcst12/. Add separate sheet for additional NA ICS codes if needed. NAICS Code Description of Work 6) Additional Information: Are you a Trucking Firm? ❑ Yes❑ No Are you a Truck Broker?['Yes❑No Both?[] Yes❑No A supplier?❑ Yes ONo 7) When submitting this application to any of the checked Certification Taskforce members, I consent to the sharing of information contained herein and declare and:r penalty of perjury that statement, in this application are true and correct. ❑ Yes ❑ No Signature Print Name Title Date North American Industry Classification System— a w.naics.com Rev. 05/2011 Page 2 of 2