Laserfiche WebLink
KITTITAS COUNTY <br />BID PROPOSAL <br />BIDDER QUALIFICATION STATEMENT <br />NAME OF FIRM: <br />ADDRESS: <br />TELEPHONE: FAX: <br />FEDERAL I.D. TAX NO. <br />TITLE & NAME OF PERSON PREPARING BID: <br />NON -COLLUSION DECLARATION <br />I, by signing the proposal, hereby declare, under penalty of perjury under the laws of the <br />United States that the following statements are true and correct: <br />1. That the undersigned person(s), firm, association or corporation has (have) not, <br />either directly or indirectly, entered into any agreement, participated in any collusion, <br />or otherwise taken any action in restrain of free competitive bidding in connection <br />with the project for which this proposal is submitted. <br />That by signing the signature page of this proposal, I am deemed to have signed and <br />have agreed to the provisions of this declaration. <br />ADDITIONAL ASSURANCE AND CERTIFICATIONS <br />Bidder hereby certifies that he/she will comply with all assurances and certifications <br />issued by Kittitas County, and conform to all applicable state and federal laws. <br />The bidder is hereby advised that by signature of this proposal he/she is deemed to <br />have acknowledged all requirements and signed all certificates contained herein. <br />FIRM NAME <br />Signature of Authorized Official <br />Type Name: <br />Title: <br />Liquid Asphalt Material Bid 2025 Page 13 of 14 <br />