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I <br /> CITY OF EVERETT SPECIAL PROVISIONS <br /> INON-COLLUSION AFFIDAVIT <br /> ISTATE OF WASHINGTON ) NON-COLLUSION AFFIDAVIT <br /> )ss <br /> I <br /> COUNTY OF SNOHOMISH ) <br /> J O,\)r S , being first duly sworn, on <br /> I his oath says that the Bid above submitted is a genuine and not a sham of collusive bid, or made in the <br /> interest or on behalf of any person not therein named; and he further says that the Bidder has not directly or <br /> indirectly induced or solicited any Bidder on the above Work or supplies to put in a sham bid, or any person <br /> or corporation to refrain from bidding; and that said Bidder has not in any manner sought by collusion to <br /> Isecure an advantage over any other Bidder or Bidders. <br /> I NOTICE TO ALL <br /> BIDDERS <br /> ITo report bid rigging activities call: <br /> 1-800-424-9071 <br /> The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through <br /> Friday, 8:00 a.m. to 5:00 p.m., Eastern Time. Anyone with knowledge of possible bid rigging, bidder <br /> collusion, or other fraudulent activities should use the"hotline"to report such activities. <br /> IThe"hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract <br /> fraud and abuse and is operated u h ' ction of the USDOT Inspector General. All information will <br /> be treated confidentially c r-anonymity, 11 be respected. <br /> I <br /> ,-----7---) 2 <br /> Sigrta2iire \,`, r" CONTRACTOR NAME <br /> Subscribed and sworn to before this•-1 day of \�CLX C^ -- , 20 \C:6, . <br /> I ‘ .01111111104,, <br /> ` ,„ THA ,, <br /> ` g4�P3, AeOs,��i� i o,AnifA� �� <br /> • <br /> .•' •'• 'S' No • ' 'ublic in and for the State of Washington <br /> I <br /> _ NOTARY PUBLIC • _ residing at \A� & V� � <br /> : COMM.EXPIRES •' <br /> AUG.09,2021 : <br /> • <br /> ��'.�9 •••••••.••(O `,. <br /> I <br /> North Wetmore Stormwater Separation Division P-PROPOSAL February 2018 <br /> Work Order No.-UP3659 SP-29 <br /> PIvided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />