24023_Exhibit-E-PCBCertification.docx

EXHIBIT E – PCB CERTIFICATION

STATUTORY PREFERENCE

FOR

PCB-FREE PRODUCTS & PRODUCTS-IN-PACKAGING

Type/print full legal name of Bidder

Pursuant to RCW 39.26.280, the Washington State Department of Enterprise Services is providing a bid preference in the amount of fifty (50) points to any bidder that provides products or products-in-packaging that do not contain Polychlorinated Biphenyls (PCBs). All bidders must certify whether they are seeking the Statutory Preference for PCB-Free Products & Products-In-Packaging.

Bidders who seek to obtain the fifty (50) point bid preference for PCB-Free Products & Products-In-Packaging must, in regard to the products and products-in-packaging pertaining to this Competitive Solicitation, certify either (a) that all of their products & products-in packaging; or (b) specific products & products-in-packaging are PCB-free. To be deemed to be ‘PCB-free,’ the applicable products must be tested, within the previous 365 days, by an independent, third-party laboratory using Environmental Protection Agency Analytical Method 1668c, and have been found NOT to contain PCBs. Such test for the applicable products must be attached to this certification.

I hereby certify, on behalf of the firm identified below, as follows (must check one):

· NO BID PREFERENCE. Bidder is NOT seeking a bid preference for PCB-Free Products & Products-In-Packaging.

OR

· BID PREFERENCE FOR ALL PRODUCTS & PRODUCTS-IN-PACKAGING. Bidder IS seeking a bid preference for all of Bidder’s products pertaining to the above referenced Competitive Solicitation. Bidder certifies that each and all of Bidder’s products identified in the above referenced Competitive Solicitation have been be tested, within the previous 365 days, by an independent, third party laboratory using Environmental Protection Agency Analytical Method 1668c, and have been found NOT to contain PCBs. Bidder further certifies that the attached test results are the official test results for such products.

OR

· BID PREFERENCE FOR SPECIFIC PRODUCTS & PRODUCTS-IN-PACKAGING. Bidder IS seeking a bid preference for Bidder’s following specific product(s) pertaining to the above referenced Competitive Solicitation. Bidder certifies that each of Bidder’s listed product(s) pertaining to the above referenced Competitive Solicitation has been tested, within the previous 365 days, by an independent, third party laboratory using Environmental Protection Agency Analytical Method 1668c, and have been found NOT to contain PCBs. Bidder further certifies that the attached test results are the official test results for such product(s).

Product: _______________________________________________________ Product: _______________________________________________________ Product: _______________________________________________________ *Add Additional lines if necessary

I hereby certify, under penalty of perjury under the laws of the State of Washington, that the certifications herein are true and correct and that I am authorized to make these certifications on behalf of the firm listed herein.

FIRM NAME:

Name of Contractor/Bidder – Print full legal entity name of firm

Print Name of person making certifications for firm

Date: ________________________________

Return this PCB Certification to Procurement Coordinator at:

DESContractsTeamCedar@des.wa.gov

EXHIBIT E – PCB CERTIFICATION FOR CONTRACT 24023 VARIABLE MESSAGE BOARDS PAGE 2

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