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CITY <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: February 8, 2016 ADDRESS: PO Box 742478 <br /> CONTRACTOR: Granite Construction CITY/STATE: Los Angeles, CA <br /> PROJECT TITLE: 2015 Hot Mix Asphalt Overlay WORK ORDER NO. PW3596 <br /> DATE WORK COMPLETE: January 7, 2016 FINAL AMOUNT: $ 4,970,297.57 <br /> Exclusive of 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 paid, and <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials <br /> from any employee of the City; I further certify that the attached final estimate is a true and correct statement <br /> showing all the monies due me from the City of Everett under this contract; that I have carefully examined said <br /> final estimate and understand the same and that I hereby release the City of Everett from any and all claims of <br /> whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in <br /> said e a -. / <br /> X �4 At X <br /> CONTRACTO 1, TITLE TITLE <br /> Granite Constru <br /> Subscribe d swo o be +re e this 1 day of n , 201 ip <br /> Notary Public <br /> otary Public State of Washington <br /> in and for the State of Washington, residing at Carol L.Johnson <br /> Commission Expires 06-08-2018 <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: 6///-7 <br /> X X -1Mtr C ' <br /> Construction Manager Public Works Director <br /> Tom Fuchs Dave Davis <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's <br /> agents and forwarded with the Final Contract Voucher Certification. <br /> Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim <br /> attached. <br /> Revised 6/2012 <br />