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City of Everett Everett Station HVAC and Controls Improvements 00 41 13 - 4 <br /> <br /> <br /> <br /> <br />00 41 13 - 4 BID FORM <br /> <br /> <br />1. A notice is considered delivered to the Bidder on the date it is emailed to <br />the email 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 />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 <br />requirements of Document 00 72 00 – GENERAL CONDITIONS and certifies that <br />coverage will be 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 <br />determined by a final and binding citation and notice of assessment issued by the <br />department of labor and industries or through a civil judgment entered by a court <br />of limited or general jurisdiction to have willfully violated, as defined in RCW <br />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 /> <br />Signed this ___________ day of _______________________, 20__ <br />Name of Bidder: _________________________________________ <br />Signature of Bidder’s Authorized Agent: _______________________ <br />City and State Where Signed: ________________________ <br />Title: ______________________________