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^-,W ffim*mi"'-*"*.' <br />Gontractor Gertificatio n <br />Wage Law Compliance - Responsibility Griteria <br />Washington State Public Works Contracts <br />FAILURE TO RETURN THIS CERTIFICATION AS PART OF THE BID PROPOSAL PACKAGE WILL <br />MAKE THIS BID NONRESPONSIVE AND INELIGIBLE FOR AWARD <br />I hereby certify, under penalty of perjury under the laws of the State of Washington, on behalf of the firm <br />identified below that, to the best of my knowledge and belief, this firm has NOT been determined by a final <br />and binding citation and notice of assessment issued by the Washington State Department of Labor and <br />lndustries or through a civiljudgment entered by a court of limited or generaljurisdiction to have willfully <br />violated, as defined in RCW 49.48.082, any provision of RCW chapters 49.46,49.48, or 49.52 within three <br />(3) years prior to the date of the Call for Bids. <br />Bidder Name:Rc\s.anq & Svrr,,,*h L^,uts*rt ichon r\L.\ <br />Name of <br />By: <br />Signature of authorized person <br />Title . Secrerf <br />Title of person certificate <br />- Print full legal entity name of firm <br />$rqo.;r ftaisc-'r <br />Print Name of person making certifications for firm <br />Place:ttle^sc*l'r-l ,WA <br />Print city and state where signed <br />Date:I -(c - A\ <br />Form272-009 <br />o812017