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POLICE HQ—MASONRY CLEANING AND REPAIR, Al'RiI., 15,2016 <br /> I <br /> • <br /> 15. By submitting this Bid,.Bidder certifies that it has reviewed the insurance requirements of the <br /> IGeneral Conditions and certifies that coverage will be-provided as required. <br /> rr <br /> Signed this ( day of J N�1e. ,20 <br /> UJ � <br /> I �nn ff� <br /> Bidder Firm Name: 'i IP►�i e et p o hq �a.so�t r� --tC ota.Ttort u- <br /> _ t� <br /> 1 <br /> Signature: �rG <br /> Title: �ref�OevL <br /> Address: 73oq, 12I Do N� <br /> City/zip: L.a,t .S-fv c M `/s2 6'67 <br /> Phone: (Na ) R3 d —7012 <br /> G►1ci.51,14A40 //1Lr'ZNW Foto nq <br /> State of Incorporation Contractor's License No. <br /> Washington'State <br /> 603 tz - 61. <br /> UBI Number <br /> 1 <br /> 113F1006 00 v <br /> Employment Security Account No. <br /> •SCRIBED and SWORN to before me this,0\ ,day of (\�v`..L ,20 tl0 <br /> N. r <br /> ' <br /> NOTARY PUBLIC in and for the State of Washington NOTARY PUBLIC <br /> STATE OF WASHINGTON <br /> My Appointment Expires: Io"�-b STA+Ct UNDSTRAND <br /> My Appointment Expires <br /> FEBRUARY 28, 2020 <br /> END OF SECTION <br /> t _ <br /> BID FORM 00 41.13-3 <br />