Always Active Services LLC of Seattle 7/21/2022

I I I II= ThisProposal form must be submitted with the Bid or as a in I Supplement to the Bid no later than 24 hours after the time for E V E R E T T delivery of the Bid Proposal, as provided for in Section 1-02.9 of WASHINGTON the Contract Provisions. ICertification of Compliance with Wage Payment Statutes I The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date May 24, 2022, the bidder is not a "willful" violator, as defined in RCW 49.48.082, of 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 Ientered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. I 1 -�tA aL S ALtNi)' .. S V R-6 LLB Bidder' 'usiness Naz4 — //� 1"1/41 Signature of Authorized Official* I h A Ickf)c , SC.iAi v Printed Name 111 OLK\JIAZr Title I Cv (-)a cW,s�, iti Date City where signed State I Check One. Sole Proprietorship Partnership 0 Joint Venture 0 Corporation 0 I State of Incorporation, or if not a corporation, State where business entity was formed: WICS1r\1 c -kir 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,. proposal must be Iexecuted by a partner INTERURBAN TRAIL TO YMCA PEDESTRIAN IMPROVEMENTS DIVISION P—WAGE COMPLIANCE WORK ORDER 3749 Page F11 of P12 MAY 2,2022 Prcwrded to Builders Exzhailge of WA, Ir.c. Fcr usage Ccnditicr.s Agreelren. see www.bxwa.ccm - Always Verity 5.:a1