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S:\GLarson\WORD\PSA Survey 2005-2006.doc <br /> 3 <br /> Exhibit D-1 Certification Of Consultant <br /> Project Name: On-Call Surveying Services <br /> City of Everett <br /> I hereby certify that I am and duly authorized representative of the firm of whose <br /> address is and that neither I,nor the above firm I here represent,has: <br /> (a) Employed or retained for a commission,percentage,brokerage, contingent fee or other <br /> consideration,any firm or person(other than a bona fide employee working solely for me or the above <br /> CONSULTANT)to solicit or secure this contract. <br /> (b) Agreed,as an express or implied condition for obtaining this contract, to employ or to <br /> retain the services of any firm or person in connection with carrying out the contract. <br /> (c) Paid,or agreed to pay,to any firm, organization or person(other than a bona fide <br /> employee working solely for me or the above CONSULTANT)any fee,contribution donation or <br /> consideration of any kind for,or in connection with procuring or carrying out the contract; except as here <br /> expressly stated(if any): <br /> I further certify that the firm I hereby represent is authorized to do business in the State of <br /> Washington and that the firm is in full compliance with the requirements of the board of Professional <br /> Registration. <br /> I acknowledge that this certificate is to be available to the State Department of Transportation <br /> and the Federal Highway Administration,U.S.Department of Transportation, in connection with this <br /> contract involving participation of Federal aid funds and is subject to applicable State and Federal laws, <br /> both criminal and civil. <br /> Date Signature <br /> Certification of Agency Official <br /> I hereby certify that I am the AGENCY Official of the Local Agency of City of Everett,Washington and <br /> that the above consulting firm or their representative has not been required, directly or indirectly as an <br /> express or implied condition in connection with obtaining or carrying out this contract to: <br /> (a) Employ or retain, or agree to employ or retain, any firm or person,or <br /> (b) Pay or agree to pay to any firm,person or organization,any fee,contribution, donation or <br /> consideration of any kind, except as here expressly stated(if any). <br /> I acknowledged that this certificate is to be available to the Federal Highway Administration,U.S. <br /> Department of Transportation,in connection with this contract involving participation of Federal aid <br /> highway funds and it subject to applicable State and Federal laws,both criminal and civil. <br /> Date Signature <br /> - 17 <br />