Exec Order 20-25 Essential Work Affidavit

Exec Order 20-25 Essential Work Affidavit

In accordance with the Governor’s Executive Order No. 20-25 Stay Home, Stay Healthy Proclamation issued 3/23/2020 and the Governor’s Clarification Memorandum of 3/252020 the following project meets the criteria outlined in the Memorandum:
Project Owner Representative Name:*
Email*
example@example.com
Project Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
This affidavit form collects essential information and documentation of the proclamation that any proposed construction activity is related to an essential project under the Governor’s Executive Order No. 20-25 issued on March 23, 2020, with formal clarification issued on March 25, 2020.

By executing the document, the undersigned herby acknowledge they have read the Governor’s Executive Order No. 20-25 issued on March 23, 2020, with formal clarification issued on March 25, 2020 and is aware of the penalties for prohibited construction activity under RCW 43.06.220(5)
Signature*

Clear
Should be Empty: