Reese Construction Company 4/27/2023

This form must be submitted with the Bid Proposal or as a Supplement to the Bid E V E R E T T no later than 24 hours after the time for delivery of the Bid Proposal,as provided for In Section 1-02.9 of the Contract Provisions. WASHINGTON Certification of Compliance with Wage Payment Statutes The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date (MARCH 21, 2023), 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 entered 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. Reece Construction Company Bidder's Business Name Signature of Authorized Official* Andy Reece Printed Name President Title o3/21/2o23 Arlington WA Date City State Check One: Sole Proprietorship ❑ Partnership ❑ Joint Venture 0 Corporation State of Incorporation, or if not a corporation, State where business entity was formed: Washington If a co-partnership, give firm name under which business is transacted: *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 executed by a partner. 2023 PAVEMENT MAINTENANCE OVERLAY WO#3789 February 14,2023 97 -rovided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal