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3 <br /> City of Everett <br /> REQUEST FOR QUALIFICATIONS <br /> RFQ No. 2014-045 <br /> Financial Advisor for Debt Issuance <br /> The undersigned hereby declares that he or she is duly authorized to complete and submit this <br /> Statement of Qualifications and that the statements contained herein are true and correct as of the <br /> date set forth below. Incomplete, incorrect or misleading information will be reason for a <br /> determination non-responsibility by the City of. Everett <br /> Dated this day of ,2014 <br /> By: <br /> (Signature of authorized representative) <br /> Name: <br /> (Please print) <br /> Title: <br /> For: <br /> 8 <br /> 13 <br />