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1 <br /> City of Everett 00 4539 - 2 <br /> 2023 Biosolids Removal UT 3808 - 2 <br /> IV, List all minority businesses from whom bids or quotes for goods or services on this <br /> Project have been solicited (attach additional sheet if necessary): I <br /> Goods or <br /> Minority Address Services Certification <br /> Business Name Involved Number <br /> Please refer to attached list of Solicited OMWBE Businesses <br /> I <br /> I <br /> r <br /> *Certification numbers (for MBE, MWBE, DBE, etc.) are found at Office of Minority &Women's <br /> Business Enterprises: httpsJ/omwbe.diversitycompliance.com/FrontEnd/SearchCertifiedDirectory.asp. <br /> If a minority business does not have a certification number, the Bidder must provide with this <br /> certification form evidence that the business is at least fifty-one percent owned by minority <br /> group members. <br /> During Contract performance, or in any event prior to final payment, Bidder shall provide 1 <br /> the City with the names and addresses of all minority businesses actually awarded <br /> subcontracts under the Contract. In the event that a subcontract bid or quote is solicited <br /> and listed above and a subcontract is not awarded to the minority business so listed, <br /> Contractor shall state the reasons such subcontract was not awarded to the minority <br /> business and shall provide the minority business quote together with the actual <br /> subcontract price paid and the name of the subcontractor to whom the subcontract was <br /> subsequently awarded, <br /> FAILURE TO PROPERLY COMPLETE AND SUBMIT THIS CERTIFICATION FORM <br /> WITH THE BID WILL RESULT IN REJECTION OF BID. THE BIDDER CERTIFIES <br /> UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF <br /> WASHINGTON THAT THE ABOVE IS TRUE AND COMPLETE CORRECT TO THE <br /> BEST OF ITS KNOWLEDGE AND BELIEF AND FURTHER AGREES TO PROVIDE <br /> INFORMATION AS REQUESTED BY THE CITY REGARDING MINORITY BUSINESS <br /> SUBCONTRACTS AND EMPLOYMENT OF MINORITY GROUP MEMBERS. <br /> Signature: a Date: December 9, 2022 <br /> ,Doug Van der Veen <br /> I <br /> END OF SECTION 00 4539 <br /> I <br /> I <br /> 00 4539 - 2 MINORITY CERTIFICATION , <br /> Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal. <br />