Neptune General Contractors 1/25/2022

I City of Everett Iwith Wage Payment Statutes Certification of Compliance g y The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date 11/23/21, the bidder is not a "willful" violator, as defined in RCW 49.48.082, of I any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I I declare under penalty of perjury under the laws of the State of Washington that the foregoing Iis true and correct. Specialty Equipment dba Neptune General Contractors IBidder's Business Name pui Tann.xsh.a ISignature of Authorized Official* I Jay Tomasko Printed Name I GM/ Member Title I 11/29/21 Anacortes City WA Date State or country ICheck One: Sole Proprietorship ❑ Partnership ❑ Joint Venture ❑ Corporation ❑X I State of Incorporation, or if not a corporation, State where business entity was formed: IWashington IIf a co-partnership, give firm name under which business is transacted: I * If a corporation, proposal must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co-partnership, Iproposal must be executed by a partner.