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I <br /> II� <br /> I <br /> CITY OF EVERETT SPECIAL PROVISIONS <br /> NON-COLLUSION AFFIDAVIT <br /> i__ <br /> STATE OF WASHINGTON ) NON-COLLUSION AFFIDAVIT <br /> I <br /> )ss <br /> COUNTY OF SNOHOMISH ) <br /> I <br /> 1 W nrn1 , being first duly sworn, on <br /> `u j <br /> his oath says that the Bi ove 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 /> I <br /> or indirectly induced or solicited any Bidder on the above Work or supplies to put in a sham bid, or any <br /> person or corporation to refrain from bidding;and that said Bidder has not in any manner sought by collusion <br /> to secure an advantage over any other Bidder or Bidders. <br /> I <br /> 1 NOTICE TO ALL BIDDERS <br /> To report bid rigging activities call: <br /> I <br /> 1-800-424-9071 <br /> The 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 possible bid rigging, bidder <br /> I;:' collusion, or other fraudulent activities should use the"hotline"to report such activities. <br /> "hotline"is part of USDOT's continuing effort to identify and investigate highway construction <br /> IThe <br /> contract fraud and abuse and is operated under the direction of the USDOT Inspector General. All <br /> information will be treated confidentially and caller anonymity will be respected. <br /> I & 0-44, . C_) <br /> Signatur CONTRACTOR NAME <br /> .),,, <br /> Subscribed and sworn to before this 1 day of J r(Y viS/ ,20 01..‘ . <br /> I <br /> 11111111111// <br /> 2± 1 <br /> 1 \\\\`.<-� F E R %i,,�� Notary Pu li in and for the State of Washington <br /> \��Q�'. \ 0 20+o,`�O residing at I(I' ✓& i VI/'� <br /> ▪ :cj �A0TARy o' <br /> I = r. BL` co - <br /> I <br /> ▪ '-V/*�c sB N 1.1 umbed• C. <br /> /////,,P VVA1SNA%\\\\�� <br /> on P-PROPOSAL October 2021 <br /> Division POE Combined Sewer Main Imp. SP- 15 <br /> 1 Work Order No.#UP3768 <br /> _ . . , l_ v�,.1.=.,no of WA. Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />