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I <br /> CITY OF EVERETT SPECIAL PROVISIONS <br /> NON-COLLUSION AFFIDAVIT <br /> STATE OF WASHINGTON NON-COLLUSION AFFIDAVIT <br /> )ss <br /> ICOUNTY OF SNOHOMISH ) <br /> fvi OS , being first duly sworn, on <br /> his oath says that the Bid above submitted is a genuine and not a sham of collusive bid, or made in the interest <br /> or on behalf of any person not therein named; and the undersigned further says that the Bidder has not directly <br /> or indirectly induced or solicited any Bidder on the above Work or supplies to put in a sham bid, or any person <br /> I or corporation to refrain from bidding;and that said Bidder has not in any manner sought by collusion to secure <br /> an advantage over any other Bidder or Bidders. <br /> I <br /> NOTICE TO ALL BIDDERS <br /> ITo report bid rigging activities call: <br /> 1-800-424-9071 <br /> IThe U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through <br /> Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of,p6ss ble bid rigging, bidder <br /> collusion, or other fraudulent activities should use the"hotline"to report such,activities: <br /> I ,� I, <br /> The "hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract <br /> fraud and abuse and is operated under the direction of the USDOT Inspector General: All information will <br /> I be treated confidentially and caller anonymity will be respected. <br /> f 62A,144-0 <br /> I , <br /> DAVI. 5 <br /> Si nature CONTRACTOR NAME <br /> 1 Subscribed and sworn to before this (27 day of afri <br /> ' , 20 2i <br /> .tit.?''•, com0410,%4.1--, <br /> •• ,y •. o s, Notary Public in and for the State of Washington <br /> s 'n <br /> • q o y�friOO19 •:� = residing at &rem,t <br /> • c <br /> U0 py X'DIR,. <br /> a •10 <br /> 7.1 <br /> i7j • • <br /> "nolo II <br /> Water Main Replacement"V" Division P—PROPOSAL April, 2021 <br /> Work Order No.—UP3730 SP-23 <br /> I <br /> Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />