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CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: July 6, 2022 ADDRESS: 15714 Country Club Dr. <br /> CONTRACTOR: McClure and Sons, Inc. CITY/STATE: Mill Creek,WA 98012 <br /> PROJECT TITLE: 2021 Trickling Filter# 1 Media Replacement WORK ORDER NO. UT-3774 <br /> DATE WORK COMPLETE: April 13, 2022 FINAL AMOUNT: $1,239,136.36 <br /> Inclusive of Washington 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 f ; 4 any and all claims of whatsoever nature which I may have, arising out of the performance of <br /> said co,t,w i re not set forth in said estimate. <br /> X dr 22 PRESIDENT <br /> NTRAC'1 TITLE <br /> ```�Zlllllll ltllllll/ <br /> McClure and Son t04 MCCC& //,,, <br /> Subscribed and sworitob4fsy'ti'S 8T day of July 2022 <br /> 0...•••• <br /> X i'14 puBUG : <br /> N tartPublic S3�4•if•• ,• <br /> In and for the Stat ' `residing at Mill Creek, Snohomish County. <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: 7-45 - ?r2Z_____ <br /> X 6)/4 431e/tt,t . X <br /> Construction Manager Public orks Director <br /> Keith Alewine 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. Contractor's Claims, if <br /> any, must be included and the Contractor's Certification must be labeled indicating a claim attached. <br /> Revised 6/2012 <br />