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• <br /> 5. <br /> • rY OF EVEn'n <br /> MAL' l'ItAeTVOILICIIER CERTIFICATION <br /> DATE: Mho-27,20.16 ADDRF$S; g67 <br /> CONTRACTOR: lamins COnstruCtion Bothell WA 98041 <br /> PROJECT TITLE: Evergreen Way Pedestrian Walkway WORK ORDER N.O. PW.3466 <br /> DATE WORK COMPLETE: May 26,2016 FINAL AMOUNT: $267,331.16 <br /> Exclusive:of State Sales Tax <br /> CONTRACTOR%Cs-EROPICATION <br /> L the undersigned, having, first been dully svron, ger* that the attached bill is •4 proper charge for work <br /> performed and Material finitishecl to the City of Everett,that the sante 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;1 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 esfimate and understand the same and that I hereby-release the City of Everett from any and all <br /> r,lainw of <br /> whatsoever:nature which I may have, arising but of the performance of said contract, which are not set forth in <br /> saki estimate. <br /> X <br /> rt <br /> X rA.P. <br /> CONTRACTOR TITLE <br /> Kamins Construction <br /> t . . NotarY Public <br /> Subscribed and svviini to before:Me thit?"33r day of <br /> X 1 NB:5-02Ar\ ,--;€1,Afate of Washington == <br /> EE CHERYL M. BOSH 12: <br /> Notary Pk) • MY COMMISSION EXPIRES = <br /> g\ NOVEMBER 22,2017 <br /> hi and for the State of Washington,residing at 1c4,10c41(31"4 kidiiti <br /> tkmmutitunttututlimututitio <br /> PUBLIC WORKS DEPARTMENT CERT 1.N <br /> I Certtfy theattacherl final estilnate tobe 1L . / (4..7 <br /> based upon actual measurements and to <br /> be true and correct. APPROVED te: 4 <br /> 01710,___ <br /> X r , <br /> A I / <br /> Construction Manager Public Wr ireotor <br /> Tom Fuchs Dave Davis <br /> INSTROCTIONS <br /> The Affidalit f\ s Paid Must 1*p-roared by th..0016 c.onfrOtor,all.pOporttractors;and all-subcontrattortS <br /> agents and forwarded with the Final.Contract Vonehet Catifieation, <br /> Contractor's Claims,,if any, Must he included and the Contactor's Certification must be labeled indicating a claim <br /> attaehed. <br /> 16 <br />