Laserfiche WebLink
RRFB PEDESTRIAN SAFETY October 31, 2025 <br />STATE FUND # HLP-PB25(004) <br />WO 3807 <br />Page 1 of 1 <br />This form must be submitted with the Bid Proposal or as a Supplement to the Bid <br />no later than 24 hours after the time for delivery of the Bid Proposal, as provided <br />for in Section 1-02.9 of the Contract Provisions. <br />Certification of Compliance with Wage Payment Statutes <br />The bidder hereby certifies that, within the three-year period immediately preceding the bid <br />solicitation date (October 07,2025 ), the bidder is not a willful violator, as defin ed in RCW <br />49.48.082, of any provision of chapters 49.46, 49.4 8, or 49.52 RCW, as determined by a final and <br />binding citation and notice of assessment issued by the Department of Labor and Industries or <br />through a civil judgment entered by a court of limited or general jurisdiction. <br />I certify under penalty of perjury under the laws o f the State of Washington that the foregoing is <br />true and correct. <br /> <br />Bidders Business Name <br />Signature of Authorized Official* <br />Printed Name <br />Title <br />Date City State <br />Check One: <br />Sole Proprietorship ☐ Partnership ☐ Joint Venture ☐ Corporation ☐ <br />State of Incorporation, or if not a corporation, St ate where business entity was formed: <br />If a co-partnership, give firm name under which bus iness is transacted: <br />* If a corporation, proposal must be executed in the corporate name by the president or vice-president <br />(or any other corporate officer accompanied by evidence of authority to sign). If a co-partnership, <br />proposal must be executed by a partner.