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I <br /> ICITY OF EVERETT SPECIAL PROVISIONS <br /> INON-COLLUSION AFFIDAVIT <br /> ISTATE OF WASHINGTON ) NON-COLLUSION AFFIDAVIT <br /> )ss <br /> COUNTY OF SNOHOMISH ) <br /> \OS-Q (\ \ C (i-f. , 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 /> I <br /> secure an advantage over any other Bidder or Bidders. <br /> INOTICE TO ALL BIDDERS <br /> ITo report bid rigging activities call: <br /> 1-800-424-9071 <br /> I <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 /> I <br /> The"hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract <br /> fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will <br /> be treated confidentially and caller anonymity will be respected. <br /> I <br /> e •yjcu .f.e c oit tch or, i-n(.. <br /> I <br /> Signature CONTRACTOR NAME <br /> Subscribed and sworn to before this \`"1 ' day of \--nO,I(( � , 20 1 C1 . <br /> RO <br /> \‘'.0 <br /> �R 4q �, lI' <br /> .I :3 <br /> •Q. S10N Et�w,9�,- <br /> i— �1 4tJ�-� <br /> irict <br /> , � cle-kLQ <br /> aPublic in and .or the State of Washington <br /> l AUC ARY :z= residing at CA n9� A <br /> .A.,__,,,.. <br /> I1O ` <br /> 1p, W15 ` <br /> / 1 <br /> IAlverson Stormwater Separation Division P—PROPOSAL February 2019 <br /> Work Order No.—UP3660 SP—23 <br /> le 28 Non-Collusion Affidavit <br /> rovided to SuifdefeSichenge of WA, Inc."For usage Conditions Agreemenfsee www.bxwa.com-Always Verify Scale <br />