KLB Construction 6/22/2016 - Laserfiche WebLink

I ' I CITY OF EVERETT SPECIAL PROVISIONS [Modified per Addendum#1] • INON-COLLUSION AFFIDAVIT v— ISTATE OF WASHINGTON ) NON-COLLUSION AFFIDAVIT )ss COUNTY OF SNOHOMISH ) I Kelly Lynn Bosa , being first duly sworn, on I his oath says that the Bid above submitted is a genuine and not a sham of collusive bid, or made in the interest or on behalf of any person not therein named; and he further says that the Bidder has not directly or indirectly induced or solicited any Bidder on the above Work or supplies to put in a sham bid, or any person or corporation to refrain from bidding; and that said Bidder has not in any manner sought by collusion to I secure an advantage over any other Bidder or Bidders. INOTICE TO ALL BIDDERS I To report bid rigging activities call: 1-800-424-9071 I The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the"hotline"to report such activities. I The"hotline" is part ofUSDOT's continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will be treated confidentially and caller anonymity will be respected. i,! i1�' : i� i `� ) �""� KLB Construction, Inc. ISignature i CONTRACTOR NAME Subscribed and sworn to before this 3rd day of May , 20 16 . 0'"' h, G Melodee A. Guinn- \\t\ �\\A, \,j` J, 5 ----- — G;�' ;�`-'eh'fy Ali Notary Public in and for the State of Washington I ��!�C iAR / �, residing at Monroe, WA I FU�LiC % 0.�'? , C1-27-20.i7Oc• ,\RG„ I ,,,..T„ , I SEWER SYSTEM REPLACEMENT AND CAPACITY IMPROVEMENTS SEWER"M" PHASE II WO No.—UP3470-10 Division P—PROPOSAL April 201E SP-23 tided to Builders Exchange of WA, Inc. For usage Conditions Agreement see wvvw.bxwa.com-Always Verify Scale