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City of Everett 00 65 19 - 2 <br /> <br /> <br /> <br /> <br /> <br /> <br />00 6519 - 2 CERTIFICATE OF COMPLETION FORM <br /> <br /> <br /> <br /> <br /> <br /> <br />DEPARTMENT CERTIFICATION <br /> <br /> APPROVED DATE:__________________ <br />I certify the attached final <br />statement to be true and correct <br />to the best of my knowledge. <br /> <br />X _______________________________ X ___________________________ <br /> Joan Olsen, Project Manager Bob Leonard, Director <br /> <br /> <br /> <br />ADMINISTRATION USE ONLY <br /> <br />Date of Final Acceptance _______________ By: X ____________________ <br /> Cassie Franklin, Mayor <br /> <br /> <br />Standard Document <br />Approved as to Form <br />Office of the City Attorney <br />(10.22.21) <br /> <br /> <br /> <br /> <br />INSTRUCTIONS <br /> <br />The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, <br />and all subcontractor's agents. <br /> <br />Contractor's Claims, if any, must be included and the Contractor's Certification must be <br />labeled indicating a claim attached. <br /> <br /> <br />END OF SECTION 00 65 19