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HomeMy WebLinkAbout12 Certification of Compliance with Wage Payment Template updated 2-12-19 12. Certificate of Compliance with Wage Payment Statutes This form must be submitted with the Bid Proposal. Certification of Compliance with Wage Payment Statutes The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date, the bidder is not a “willful” violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Bidder’s Business Name Signature of Authorized Official* Printed Name Title Date City State Check One: Sole Proprietorship ☐ Partnership ☐ Joint Venture ☐ Corporation ☐ LLC ☐ State of Incorporation, or if not a corporation, State where business entity was formed: If a co-partnership, give firm name under which business is transacted: *If a corporation, proposal must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co-partnership, proposal must be executed by a partner.