ATTACHMENT D1 Wage Cert.pdf
PDF 126 KB Posted
- Attached to
- Behavior Specialist Services
- Solicitation number
- RFP# 2024-07-22
- Issued by
- King County, Snohomish County, Kingston CDP, Snohomish City, Washington
About this file
This document is an ATTACHMENT D1 Contractor Certification for the Northshore School District's Goods & Services Contracts. It requires bidders to certify whether they have or have not willfully violated Washington's wage laws within the past three years, as a condition of being considered a responsible bidder.
The related state and local contract opportunity is for Behavior Specialist Services. The District is seeking an experienced, qualified provider of behavior specialists to support the behavior needs of special education and other identified students. The District intends to award multiple one-year contracts with four optional one-year extensions. The contract opportunity covers the jurisdictions of King County, Snohomish County, Kingston CDP, and Snohomish City within the state of Washington.
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ATTACHMENT D1
CONTRACTOR
CERTIFICATION
Wage Theft Prevention – Responsible Bidder Criteria Northshore School District Goods & Services
Contracts
Prior to awarding a contract, Northshore School District is required to determine that a bidder is a ‘responsible bidder’. Pursuant to legislative enactment in 2017, RCW 39.26.160(2) & (4) requires responsible bidder criteria to include contractor certification that the contractor has not willfully violated Washington’s wage laws.
On behalf of the firm identified below, I hereby certify as follows (check one):
¨ No Wage Violations. This firm has NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of RCW chapters 49.46, 49.48, or 49.52within three
(3) years prior to the date of the above-referenced procurement solicitation date.
or
¨ Violations of Wage Laws. This firm has been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, a provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.
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
By:
Signature of authorized person Print Name of person making certifications for firm
Title: Place:
Print city and state where signed Title of person signing certificate
Date:
http://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 http://app.leg.wa.gov/RCW/default.aspx?cite=49.46 http://app.leg.wa.gov/RCW/default.aspx?cite=49.46 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48 http://app.leg.wa.gov/RCW/default.aspx?cite=49.52 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 http://app.leg.wa.gov/RCW/default.aspx?cite=49.46 http://app.leg.wa.gov/RCW/default.aspx?cite=49.46 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48 http://app.leg.wa.gov/RCW/default.aspx?cite=49.48 http://app.leg.wa.gov/RCW/default.aspx?cite=49.52
| CONTRACTOR CERTIFICATION |
| On behalf of the firm identified below, I hereby certify as follows (check one): |
| Firm Name: |
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