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I <br /> 1 CITY OF EVERETT PUBLIC WORKS 00 45 19 <br /> SPECIAL PROVISIONS NONCOLLUSION AFFIDAVIT <br /> IDOCUMENT 00 45 19-NONCOLLUSION AFFIDAVIT <br /> I <br /> 1.1 GENERAL <br /> IA. Bidder shall fill out affidavit below, notarize,and include with Bid. <br /> II STATE OF WASHINGTON <br /> ) ss. <br /> COUNTY OF Cowlitz ) <br /> I <br /> R.E. Kinghorn ,being first duly sworn,on his/her oath says that the Bid <br /> I 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 /> I 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 /> ----"el""A4,/" <br /> I Stellar J Corporation ` <br /> Firm Name R.E. Kinghorn, President AuthorizeSignature <br /> ISUBSCRIBED and SWORN to before me this 12thday of June .2018. <br /> I ititi <br /> NOTARY UBLIC in and for the State of Washington,residing at Woodland,WA <br /> I <br /> My commission expires: July 28th,2018 <br /> •NN: TREND OF DOCUMENT 00 45 19 .�`AN.•...•...Uti1 <br /> giz <br /> I <br /> B'�., <br /> \� (2-e•�Sst O/v/ •••,O. <br /> _:rn;o�vt1OTA !4 <br /> I <br /> N�It PURLG _ <br /> C? <br /> /*•/-A-iii <br /> WASH\oNNN <br /> I <br /> I <br /> PROCESS WATER PUMP STATION 02/27/2018 <br /> I <br /> WO-3647 00 45 19- 1 <br /> Iovided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />