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City of Everett 00 4113 - 5 <br />2026 WPCF Biosolids Removal & Disposal UT 3752-30 <br /> <br /> <br /> <br />00 4113 - 5 BID FORM <br /> <br />A. By submitting this Bid, Bidder certifies that it has reviewed the insurance <br />requirements of Document 00 7200 – 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 <br />immediately preceding the bid solicitation date for this Project, the Bidder has not <br />been determined by a final and binding citation and notice of assessment issued <br />by the department of labor and industries or through a civil judgment entered by <br />a court of limited or general jurisdiction to have willfully violated, as defined in <br />RCW 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 _______________________, 2025 <br />Name of Bidder: _________________________________________ <br />Signature of Bidder’s Authorized Agent: _______________________ <br />City and State Where Signed: ________________________ <br />Title: ______________________________ <br />Phone: ____________________________ <br /> <br />State of Incorporation _____________Contractor’s License No._________ <br /> Washington State___________ <br />Email address of Bidder’s authorized Agent: <br />_______________________________ <br /> <br /> <br />The remainder of this page intentionally left blank <br />