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CITY OF EVERETT, WASHINGTON <br />CONTRACT PROVISIONS FOR <br />WORK ORDER NO.: PW 3860 <br />2026 Pavement Maintenance Overlay Instructions to Bidders <br />PW# 3860 March 5, 2026 <br />5.0 Pre-Award Forms: Supplemental Responsibility Criteria Certifications <br />The following supplemental responsibility criteria are in addition to any other Project <br />supplemental responsibility criteria that may be in the bidding documents. <br />A. Wage Compliance. The following Supplemental Bidder Responsibility Criterion applies <br />to this Project: <br />Extended Certification of Wage Compliance. Within the five-year period <br />immediately preceding the date of the bid solicitation, the Bidder must not have <br />been determined by a final and binding citation and notice of assessment issued by <br />the department of labor and industries or through a civil judgment entered by a <br />court 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. <br />B. Apprentice Utilization: The following Supplemental Bidder Responsibility Criterion <br />applies to this Project if this Project has apprentice utilization requirements: <br />Certification of Apprentice Compliance. For each public project completed by <br />Bidder during the two-year period immediately preceding the date of the bid <br />solicitation, Bidder must not have been subject to a final determination by the <br />awarding agency that Bidder failed, without good faith efforts approved by the <br />awarding agency, to meet applicable project apprentice utilization requirements. <br />C. Form of Required Certification(s): Before Project award, Bidder must submit the <br />following fully executed to the City: <br />The undersigned hereby certifies that, within the five-year period immediately preceding the bid <br />solicitation date for this Project, the Bidder has not been determined by a final and binding citation <br />and notice of assessment issued by the department of labor and industries or through a civil judgment <br />entered by a court 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 undersigned declares under <br />penalty of perjury under the laws of the State of Washington that the foregoing sentence is true and <br />correct. <br />If the Project is subject to apprentice utilization requirements, Bidder also certifies: For each public <br />project completed by Bidder during the two-year period immediately preceding the date of this Bid <br />solicitation, no awarding agency has made a final determination that Bidder failed, without good faith <br />efforts approved by the awarding agency, to meet applicable project apprentice utilization <br />requirements. <br />Signed this ___________ day of _______________________, 20__ <br />Name of Bidder: _________________________________________ <br />Signature of Bidders Authorized Agent: _______________________ <br />City and State Where Signed: ________________________