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CITY OF EVERETT <br />FINAL CONTRACT VOUCHER CERTIFICATION <br />DATE: August 29, 2022, 2022 <br />CONTRACTOR: Northwest Construction, Inc. <br />PROJECT TITLE: POE Combined Sewer Main Improvements <br />DATE WORK COMPLETE: June 28, 2022 <br />ADDRESS: 2353 130t}1 Avenue NE, Ste 100 <br />CITY/STATE: Bellevue, WA 98005 <br />WORK ORDER NO UP-3730 <br />FINAL AMOUNT: $8,974,814.64 <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 foi 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 ti ue 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 hei eby 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 contract, which are not set forth in said estimate. <br />X <br />X Prcsject MCiAase✓ <br />CONTRACTOR TITLE <br />Northwest Construction, Inc. <br />Subscribed and sworn to before me this <br />I <br />X �I�-��� <br />Notary Public <br />1 <br />MELANIE PIDGEON <br />Notary Public <br />State of Washington <br />License Number 206920 <br />My Commission Expire <br />March 25, 2023 PUB <br />I in-' <br />ngton, residing at <br />day of JPK\o -Y , 2023 <br />Calpv ✓•-0 Le -De <br />IC WORKS DEPARTMENT CERTIFICATION <br />I Certify the attached final estimate to be <br />based upon actual measurements and to <br />be true and correct. <br />r <br />X <br />Construction Manager <br />Keith Alewine <br />APPROVED Date: l <br />X <br />Pu Ylc Works Director <br />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. Conti actor's Claims, if <br />any, must be included and the Conti actor's Certification must be labeled indicating a claim attached. <br />Revised 6/2012 <br />