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Sample 10/4/2023
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Sample 10/4/2023
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Entry Properties
Last modified
10/4/2023 11:17:38 AM
Creation date
10/4/2023 10:58:04 AM
Metadata
Fields
Template:
Contracts
Contractor's Name
Sample
Approval Date
10/4/2023
Department
Legal
Department Project Manager
Tim Benedict
Subject / Project Title
Test
Tracking Number
0003969
Total Compensation
$0.00
Contract Type
Agreement
Contract Subtype
Professional Services (PSA)
Retention Period
6 Years Then Destroy
Imported from EPIC
No
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CITY OF EVERETT SPECIAL PROVISIONS <br /> <br />Beverly Lake Water Quality RetrofitDivision P – PROPOSAL August 2023 <br />Work Order No. – UP3745 SP – 20 <br />NON-COLLUSION AFFIDAVIT <br /> <br /> <br /> <br />STATE OF WASHINGTON ) <br /> ) ss <br />COUNTY OF SNOHOMISH ) <br /> <br /> <br />The Undersigned, being first duly sworn, on oath says that the Bid above submitted is a genuine and not a <br />sham of collusive bid, or made in the interest or on behalf of any person not therein named; and the undersigned <br />further says that the Bidder has not directly or indirectly induced or solicited any Bidder on the above Work <br />or supplies to put in a sham bid, or any person or corporation to refrain from bidding; and that said Bidder has <br />not in any manner sought by collusion to secure an advantage over any other Bidder or Bidders. <br /> <br /> <br /> <br /> <br /> <br />Firm Name Authorized Signature <br /> <br /> <br /> <br />SUBSCRIBED and SWORN to before me this _____ day of ______________, 20_____. <br /> <br /> <br /> <br /> NOTARY PUBLIC in and for the State of <br /> Washington, residing at <br /> <br /> My commission expires: <br /> <br /> <br /> <br /> <br />NOTICE TO ALL BIDDERS <br /> <br />To report bid rigging activities call: <br /> <br />1-800-424-9071 <br /> <br />The U.S. Department of Transportation (USDOT) operates the above toll-free “hotline” Monday through <br />Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of possible bid rigging, bidder <br />collusion, or other fraudulent activities should use the “hotline” to report such activities. <br /> <br />The “hotline” is part of USDOT’s continuing effort to identify and investigate highway construction contract <br />fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will <br />be treated confidentially and caller anonymity will be respected. <br /> _________________________________
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