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City of Everett 00 41 13 - 3 <br /> Fire Administration Building Tenant Improvements (Rev. A)18-1080 'f <br /> employee of the City is personally or financially interested, directly or indirectly, in the <br /> Proposal, or in any purposes of, or the sale of, any materials or supplies for the work to <br /> which it relates, or any portion of the profits thereof. <br /> 12. Undersigned acknowledges that Addenda Numbers / through have <br /> been received, examined, and taken into account as part of the Bid. Note: signed copies <br /> of all addenda must be submitted with the Bid. <br /> 13 DESIGNATED REPRESENTATIVE <br /> Undersigned hereby designates /eiv Dh / _ &S o N ( ,GP FAe s,be,i''of its <br /> office to which notice of acceptance of this Bid may be fnailed or delivered. <br /> 14. The full names and residences of all persons and parties interested in this Bid as principals <br /> are as follows: <br /> NAME TITLE ADDRESS <br /> M k- GO I Pit� Prey- /Co-Me e✓ 1152- F 1 k_3() c tit ,C646--cd,vtvt eM lLI <br /> Tom lejst., \f 2recyc&v`*/CO j V 'Th7DAc\ vac- >r SE ,fro CIV-- D <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 /> Signed this 0( day of , 20 a 0 <br /> Bidder Firm Na e: e U - CU I , >C��zfeS t I (- <br /> Signature: <br /> Gfj.J � . <br /> / <br /> Title: PrrssAesr*/CC)- N aoacie r <br /> Address:2R�0 J k=es, R�� , ���lt <br /> City/Zip: Si -d-t , c1 R%-b 1 <br /> Phone: 42.�-(0c1-0(400 <br /> State of Incorporation Contractor's License No. <br /> Washington State <br /> �t(ZTLR1.��-t5l BC- <br /> 00 41 13 - 3 (Revision A 5/14/2020) BID FORM <br />