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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> CONTRACTOR: Thomco Construction, Inc. ADDRESS: 13700 44th Street NE <br /> CITY: Lake Stevens STATE: WA 98674 DATE: July 1, 2019 <br /> PROJECT TITLE: North Wetmore Stormwater Separation Project <br /> WORK ORDER NO. UP 3659 <br /> DATE WORK COMPLETE: May 21, 2019 FINAL AMOUNT: $3,221,236.23 (includes WSST) <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, <br /> and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or <br /> materials from any employee of the City; I further certify that the attached final estimate is a true and correct <br /> statement showing all the monies due me from the City of Everett under this contract; that I have carefully <br /> examined said final estimate and understand the same and that I hereby release the City of Everett from any <br /> and all claims of whatsoever nature which I may have, arising out of the performance of said contract, which <br /> are not set forth'in said estimate. ` ,����""""i,,,, <br /> k`k PM ,ANTHAA i/,- <br /> XX •• <br /> CONTRACTOR TITLE a N�1ARVpUOtiG•. S. <br /> Thomco/Construction,Inc. _ : COMM.L'Xp►Rfs <br /> AUG.09,2021 • z <br /> Subscribed and sworn to before ? N • <br /> me this.! s day of ' , ,, Lt.: t 9�••. .••�� <br /> X a� �t ,_ L, ()0r ._ Notary Public 1- ---''�OFWASHtNC'�0.•‘�� <br /> in and for the State of Washington, residing at L,- E - � '` ' C�- ,,,,,,,,i,00- <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final APPROVED Date: (-Pi Z02-0 <br /> estimate to be based upon actual <br /> measurements and 4 to be true and correct. <br /> X , X <br /> Construction Manager Utilities Director <br /> Tom Fuchs Ryan Sass <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all <br /> subcontractor's agents and forwarded with the Final Contract Voucher Certification. <br /> Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a <br /> claim attached. <br /> Revised 9/94 <br />