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City of Everett 00 41 13 - 7 <br />Port Gardner Storage Facility - Facility Construction Package WO# UP-3525 <br />00 41 13 - 7 BID FORM <br />D. Bidder certifies that its Bid is in all respects fair, and is made without collusion on the <br />part of any person, firm, or corporation mentioned below, and that no officer or <br />employee of the City is personally or financially interested, directly or indirectly, in the <br />Bid, or in any purposes of, or the sale of, any materials or supplies for the work to which <br />it relates, or any portion of the profits thereof. <br />1.7 DESIGNATED/AUTHORIZED REPRESENTATIVE <br />A. Bidder designates ____________________________________ of its office to which <br />notice of acceptance of this Bid may be mailed, emailed or delivered. <br />B. City may provide notice of any kind to the Bidder using the email address Bidder <br />provides below. <br />C. A notice is considered delivered to the Bidder on the date it is emailed to the email <br />address. <br />1.8 INTERESTED PARTIES <br />A. The full names and residences of all persons and parties interested in this Bid as <br />principals are as follows: <br />B. NAME TITLE ADDRESS <br />_______________________________________________________________ <br />_______________________________________________________________ <br />_______________________________________________________________ <br />1.9 BID FORM SIGNATURES <br />A. By submitting this Bid, Bidder certifies that it has reviewed the insurance requirements <br />of Document 00 72 00 – GENERAL CONDITIONS and certifies that coverage will be <br />provided as required. <br />B.The undersigned also hereby certifies that, within the five-year period immediately <br />preceding the bid solicitation date for this Project, the Bidder has not been determined by <br />a final and binding citation and notice of assessment issued by the department of labor <br />and industries or through a civil judgment entered by a court of limited or general <br />jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of <br />chapter 49.46, 49.48, or 49.52 RCW. The undersigned declares under penalty of perjury <br />under the laws of the State of Washington that the foregoing sentence is true and correct.