Common use of Certification of Compliance with Wage Payment Statutes Clause in Contracts

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements Project, 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 ☐ 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements Project2020 ANNUAL DRAINAGE PROJECT, 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 ☐ 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-co- partnership, proposal must be executed by a partner. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements Project2020 ANNUAL DRAINAGE PROJECT, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements 2022 Road Striping Project, 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 ☐ 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-co- partnership, proposal must be executed by a partner. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 2022, for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements 2022 Road Striping Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements ProjectXXXXXXXXX PARK OUTFALL PROJECT, 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 ☐ 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements ProjectXXXXXXXXX PARK OUTFALL PROJECT, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements 2021 Road Striping Project, 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 ☐ 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 2021, for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements 2021 Road Striping Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements 2020 Road Striping Project, 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 ☐ 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements 2020 Road Striping Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements Grinder Pump Replacement(s) Project, 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 ☐ 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements Grinder Pump Replacement(s) Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and

Certification of Compliance with Wage Payment Statutes. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date for the Concrete Sidewalk Replacements 2021 ANNUAL DRAINAGE Project, 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 ☐ 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- 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. Payment Bond KNOW ALL PEOPLE BY THESE PRESENTS: BOND NO.: That we, , the CONTRACTOR, herein referred to as PRINCIPAL, and , as SURETY, are held and firmly bound unto THE CITY OF BAINBRIDGE ISLAND (hereinafter the “OWNER”) in the full sum of dollars ($ ), lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITIONS of this obligation are such that, whereas, the PRINCIPAL has entered into an agreement in writing with the OWNER, dated , 20 , for the construction of the City of Bainbridge Island’s Concrete Sidewalk Replacements 2021 ANNUAL DRAINAGE Project, according to the terms, conditions, and covenants specified in the Contract including all of the Contract Documents therein referred to, which are hereby referred to and made a part hereof as fully and completely as though set forth in detail herein, and