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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: December 1, 2020 ADDRESS: 1525 E. Marine View Drive <br /> CONTRACTOR: Granite Construction Company CITY/STATE: Everett, WA 9820 I <br /> PROJECT TITLE: 2020 Pavement Maintenance Overlay WORK ORDER NO. PW 3727 <br /> DATE WORK COMPLETE: October 9, 2020 FINAL AMOUNT: $3,065,171.98 <br /> Exclusive of State Sales Tax <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 <br /> paid,and that I am authorized to sign for the claimant;that I have not rented or purchased any equipment <br /> or materials from any employee of the City; I further certify that the attached final estimate is a true and <br /> correct statement showing all the monies due me from the City of Everett under this contract; that I have <br /> carefully examined said final estimate and understand the same and that I hereby release the City of <br /> Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of <br /> said c r , hich are not set forth in said estimate. <br /> X v x AVi-C a 41/44AWA to 6K— <br /> CONTRACTOR TITLE <br /> Granite Construction Company <br /> Subscr- e and s orn to before nee this day of ck, f ,a03- j <br /> Notary Public <br /> x State of Washington <br /> Notary Pu is Carol L. Johnson <br /> in and for the State of Washington, residing at t\ u Commission Expires 06-08-2022 <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and correct. APPROVED Date: /-Oc-ZO2, <br /> x . qae✓L X_ <br /> Construction Manager Publ. Works Director <br /> Tom Fuchs Ryan Sass, P.E. <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 6/2012 <br />