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City of Everett 00 41 13 - 4 00 41 13 - 4 BID FORM C. Bidder agrees to provide upon written request of the City all information related to its qualifications and those of its key personnel and its proposed Subcontractors. D. Bidder certifies that its Bid is in all respects fair, and is made without collusion on the part of any person, firm, or corporation mentioned below, and that no officer or employee of the City is personally or financially interested, directly or indirectly, in the Bid, or in any purposes of, or the sale of, any materials or supplies for the work to which it relates, or any portion of the profits thereof. 1.7 DESIGNATED/AUTHORIZED REPRESENTATIVE A. Bidder designates ____________________________________ of its office to which notice of acceptance of this Bid may be mailed, emailed or delivered. B. City may provide notice of any kind to the Bidder using the email address Bidder provides below. 1. A notice is considered delivered to the Bidder on the date it is emailed to the email address. 1.8 INTERESTED PARTIES A. The full names and residences of all persons and parties interested in this Bid as principals are as follows: NAME TITLE ADDRESS _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 1.9 BID FORM SIGNATURES A. By submitting this Bid, Bidder certifies that it has reviewed the insurance requirements of Document 00 72 00 – GENERAL CONDITIONS and certifies that coverage will be provided as required. B. The undersigned also hereby certifies that, within the three-year period immediately preceding the bid solicitation date for this Project, the Bidder has not been 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 to have willfully violated, as defined in RCW 49.48.082, any provision of chapter 49.46, 49.48, or 49.52 RCW. The