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I <br /> CITY OF EVERETT PUBLIC WORKS 00 45 19 <br /> I <br /> SPECIAL PROVISIONS NONCOLLUSION AFFIDAVIT <br /> IDOCUMENT 00 45 19-NONCOLLUSION AFFIDAVIT <br /> 1.1 GENERAL <br /> IA. Bidder shall fill out affidavit below,notarize, and include with Bid. <br /> I <br /> STATE OF WASHINGTON ) <br /> ) ss. <br /> COUNTY OF Pi trc ) <br /> I <br /> fiAlf\\C oo�cf e , Ji. ,being first duly sworn, on his/her oath says that the Bid <br /> Iabove 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 /> Icorporation 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 /> 1 <br /> Rootoq . Ins ovi Inc- —1--,�____s? <br /> Firm Name Authorized Sip(aburL <br /> SUBSCRIBED and SWORN to before me this,- of \(\\-\‘..�C.k�'I, 20115 <br /> �' ud Q. C_Cid Cat(' <br /> INOT Y PUBLIC in and for the State of Washington,residing at ( AT\(I( LAD A <br /> My commission expires: C1 115'ao <br /> i , <br /> Roo,,,,,0111llltl,�i <br /> END OF DOCUMENT 00 45 19 ( j' 1A \ <br /> • 4e' <br /> PUBS z _ <br /> I ,0.„ sV i alto 4a. <br /> �,�. <br /> ,,,,O w 1g' ``' <br /> to1 <br /> I <br /> I <br /> Legion Golf Course Stormwater Detention Project November 30, 2017 <br /> IWO#UP3620 00 45 19 - 1 <br />