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I <br /> City of Everett 00 41 13 - 3 <br /> Everpark Garage Repairs 2018-034 <br /> I13 DESIGNATED REPRESENTATIVE <br /> Bill Parks of its <br /> I Undersigned hereby designates <br /> office to which notice of acceptance of this Bid may be mailed or delivered. <br /> I14. The full names and residences of all persons and parties interested in this Bid as <br /> principals are as follows: <br /> INAME TITLE ADDRESS <br /> 15. By submitting this Bid, Bidder certifies that it has reviewed the insurance requirements of <br /> the General Conditions and certifies that coverage will be provided as required. <br /> ISigned this 9th day of July 20 19 <br /> Bidder Firm Name: FD Thomas, Inc . <br /> ISignature:o,r4/,7./47,--------- <br /> Title: Vice President <br /> IAddress: 7450 S . 212th St <br /> III <br /> City/Zip: Kent, WA 98032 <br /> Phone: 253-548-1600 <br /> I <br /> State of Incorporation Contractor's License No. <br /> IWashington State <br /> 601-420-129 <br /> I UBI Number <br /> 755782-00-2 <br /> Employment Security Account No. <br /> I <br /> SUBSCRIBED and SWORN to before me this 9th day of July , 20 19 <br /> I •••‘... „"I I <br /> NOTARY PUBLIC in and for the State of Washington ;:;k3ER Hp 'si/� <br /> I My Appointment Expires: �I3IZZ r ' 0T44). il <br /> 0 '� �'� <br /> S '° 204618 °' <br /> IEND OF SECTION 004113 y/y '44? 3N <br /> 00 41 13 - 3 (Revision A 6/19/19) BID FORM <br />