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City of Everett Inductive Charging Infrastructure for Field Installation 00 4113 - 5 <br /> been determined by a final and binding citation and notice of assessment issued <br /> ' by the department of labor and industries or through a civil judgment entered by <br /> a court of limited or general jurisdiction to have willfully violated, as defined in <br /> RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW. The <br /> undersigned declares under penalty of perjury under the laws of the State of <br /> Washington that the foregoing sentence is true and correct. <br /> ' Signed this day of , 2022 <br /> Name of Bidder: <br /> Signature of Bidder's Authorized Agent: <br /> City and State Where Signed: <br /> Title: <br /> Phone: <br /> ' State of Incorporation Contractor's License No. <br /> Washington State <br /> Email address of Bidder's authorized Agent: <br /> I <br /> I <br /> I <br /> The remainder of this page intentionally left blank <br /> I <br /> I <br /> 00 4113 - 5 BID FORM <br /> 1 <br />