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CITY OF EVERETT PUBLIC WORKS <br /> SPECIAL PROVISIONS <br /> DOCUMENT 004519-NONCOLLUSION AFFIDAVIT <br /> 1.1 GENERAL <br /> A. Bidder shall fill out affidavit below,notarize,and include with Bid. <br /> STATE OF WASHINGTON ) <br /> ) ss. <br /> COUNTY OF King ) <br /> Matt Vernon ,being first duly sworn,on his/her oath says that the Bid <br /> above submitted is a genuine and not a sham of collusive bid,or made in the interest or on behalf of <br /> any person not therein named; and he further says that the Bidder has not directly or indirectly induced <br /> or solicited any Bidder on the above Work or supplies to put in a sham bid,or any person or <br /> corporation to refrain from bidding; and that said Bidder has not in any manner sought by collusion to <br /> secure an advantage over any other Bidder or Bidders. <br /> Kassel & Associates, Inc. 17 <br /> Firm Name Authorized Signature Matt Vernon <br /> SUBSCRIBED and SWORN to before me this 31st day of January ,2017. <br /> NOTARY P :LI IV and for the State of Washington,residing at Carnation, Washington <br /> My commission expires: 04-10-19 <br /> END OF DOCUMENT 004519 <br /> WFP Operations Building Seismic Retrofit-Rebid January 6, 2017 <br /> WO#UP3600 004519- 1 <br /> Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />