Laserfiche WebLink
CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: October 8, 2021 ADDRESS: PO Box 418 <br /> CONTRACTOR: Combined Construction, Inc. CITY/STATE: Mukilteo,WA 98275 <br /> PROJECT TITLE: Maple Heights Bridge Seismic Retrofit WORK ORDER NO. PW3693 <br /> DATE WORK COMPLETE: June 29th, 2021 FINAL AMOUNT: $566,290.79 <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 ct. is are th in said estimate. <br /> X S/GCS i <br /> TITLE ,0��aa..C�nst� <br /> struction, Inc. :Vo.: coRp0R�...C <br /> �•...? <br /> .... <br /> a <br /> Subscri ands n to before me this 2 day of Otlo✓ , 20Z1 ,: . 4L4 L .•0 1 <br /> X ��.���.,,o uisp, ' , • <br /> ''�,� •!NG1o?••• \`,; <br /> ♦ '�.••ENT,,.O ���4 'i,/ 0• , \�� <br /> Notar dtssn i,s, ;G ''��ittttit,,\‘ <br /> in and for�thg0 ��F�ington, residing at <br /> 7:-. *. PusLIG : :47 5.W-k4-11/34 \kik <br /> 7kOFAs t. <br /> �gI�hgo uLIC 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: 11-Z3 _Z''2! <br /> X X 1� <br /> J---- <br /> City Engineer Pub ' Works Director <br /> Tom Hood Ryan Sass <br /> Revised 6/2012 <br />