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IE Final Contract <br />Voucher Gertificate <br />10 <br />EVERETI <br />l, the undersigned, certiry and declare, under penalty of perjury under the laws of the State of Washington, that the <br />foregoing is true and correct: I am authorized to sign for the claimant; that in connection with the work performed and, <br />to the best of my knowledge, no loan, gratuity or gift in any form whatsoever has been extended to any employee of <br />the City of Everett, nor have I rented or purchased any equipment or materials from any employee of the Crty of <br />Everett; that the attached final estimate is a true and correct statement showing allthe monies due the claimant from <br />the Cjty of Everett for work performed and material furnashed under this Contract; that I have carefully examined said <br />final estimate and understand the same and; that l, on behalf of the claimant, hereby release and forever discharge <br />the City of Everett from any and all claims of whatsoever nature which I or the claimant may have, arising out of the <br />performance of said Contract, which are not set forth in said final estimate. <br />(City, State) <br />22nd January <br />this <br />- <br />day of <br />Office Manager <br />Tifle <br />e"tA <br />Contractor Authorized Signature <br />David Pankiewicz <br />Printed Name <br />R.L. Alia Company <br />Street Address 10831 SE 181st St <br />City Renton State zip 90855 Date 12l7l202s <br />Work Order No. <br />u P-3745 <br />Project Tifle Beverly Lake Water Quality Retrofit <br />Date Work Physically Completed 811612024 FinalAmount <br />s1,1s8,077.99 <br />I certify to the best of my knowledge the attached flnal <br />estimate to be based upon actual measurements and to <br />be true and correct. <br />Approved Date Oz - o3 -Zoz-e <br />Keith Alewine, Construction Manager Ryan . Director of Public Works <br />The Affidavit of Wages Paid must be prepared by the prime contraclor, all subcontractors, and all subconkactor's agents <br />and fonruarded with the Final Contract Voucher Certification. Contractor's Claims, if any, must be included and the <br />Contractor's Certification must be labeled indicating a claim attached. Scanned and/or e-signatures have same effect as <br />ink signatures. <br />Contractor <br />Contractor's Certif ication <br />Renton, WA <br />DATED at <br />-- <br />20 <br />Public Works Department Certification <br />Kud /4/z--r.