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City of Everett 00 6519 - 1 <br /> 2020 Trickling Filter Media Replacement UP 3742-2 <br /> SECTION 00 6519 -CERTIFICATE OF COMPLETION FORM <br /> CONTRACTOR: Stellar J Corporation <br /> ADDRESS:1363 Down River Drive <br /> CITY: Woodland STATE: WA DATE: 6/22/2021 <br /> PROJECT TITLE: 2020 Trickling Filter Media Replacement PROJECT NO. UP 3742-2 <br /> DATE WORK COMPLETED: 4/08/2021 FINAL CONTRACT AMOUNT: <br /> $ 1,209,327.05 <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached statement is a <br /> proper charge for work performed and material furnished to the City of Everett, that the <br /> same or any part thereof has not been paid, and that I am authorized to sign for the <br /> claimant; that I have not rented or purchased any equipment or materials from any <br /> employee of the City; I further certify that the attached final statement is a true and correct <br /> statement showing all the moneys due me from the City of Everett under this contract; that I <br /> have carefully examined said final statement and understand the same and that I hereby <br /> release the City of Everett from any and all claims of whatsoever nature which I may have, <br /> arising out of the performance of said contract, which are not set forth in said statement. <br /> X _./i.,,--..imo►. _/ X `'1014G/ .%%/�1!,�"G.e <br /> ONTri*CTO' t/ TITLE / <br /> 0iiiiiii silo, <br /> Subscribed an • n to before ���•``�ft,��µEN��eS000 ,�� <br /> m his 1 d of Nov wvbetr `'j• v- F+"�R`'s <br /> X :4 OTA9 - ' <br /> Notary Public _ 0 <br /> in an r the State of Washington, residing 'Q "''"' y <br /> a• �0(ig��G •„z <br /> ato4dlur� 1 . -7A••°tir Do •o <br /> �` ag •. <br /> Oi• C, <br /> ".,,, WASN,c,r <br /> DEPARTMENT CERTIFICATION """ ,1!t <br /> APPROVED Date: I %'c11- a,1 <br /> I Certify the attached final <br /> statement to be true and correct <br /> to the best of my knowledge. <br /> 00 6519 - 1 CERTIFICATE OF COMPLETION FORM <br />