2004/03/10 Council Agenda Packet

J:\Contracts\Environmental\Everett\PH1V 41st Environ Cont 1-9-04.doc 10 Exhibit D-1 Certification Of Consultant Project No. City of Everett I hereby certify that I am Kevin E. Weed and duly authorized representative of the firm of Perteet Engineering,Inc.whose address is 2707 Colby Avenue, Suite 900,Everett,WA 98201 and that neither I,nor the above firm I here represent,has: (a) Employed or retained for a commission,percentage,brokerage, contingent fee or other consideration, any firm or person (other than a bona fide employee working solely for me or the above CONSULTANT) to solicit or secure this contract. (b) Agreed, as an express or implied condition for obtaining this contract, to employ or to retain the services of any firm or person in connection with carrying out the contract. (c) Paid, or agreed to pay,to any firm, organization or person(other than a bona fide employee working solely for me or the above CONSULTANT) any fee, contribution donation or consideration of any kind for, or in connection with procuring or carrying out the contract; except as here expressly stated (if any): I further certify that the firm I hereby represent is authorized to do business in the State of Washington and that the firm is in full compliance with the requirements of the board of Professional Registration. I acknowledge that this certificate is to be available to the State Department of Transportation and the Federal Highway Administration,U.S. Department of Transportation, in connection with this contract involving participation of Federal aid fund&and is subject to applicable State and Federal laws, both crimina nd civil. Date 1(cA 1 OH- Signature Certification of Agency Official I hereby certify that I am the AGENCY Official of the Local Agency of Washington and that the above consulting firm or their representative has not been required,directly or indirectly as an express or implied condition in connection with obtaining or carrying out this contract to: (a) Employ or retain,or agree to employ or retain,any firm or person,or (b) Pay or agree to pay to any firm,person or organization, any fee, contribution, donation or consideration of any kind,except as here expressly stated (if any). I acknowledged that this certificate is to be available to the Federal Highway Administration,U.S.Department of Transportation,in connection with this contract involving participation of Federal aid highway funds and it subject to applicable State and Federal laws,both criminal and civil. Date Signature 96