Interwest Construction 12/5/2016

CITY CITY OF EVERETT FINAL CONTRACT VOUCHER CERTIFICATION DATE: September 8, 2016 ADDRESS: 609 North Hill BLVD CONTRACTOR: Interwest Construction CITY/STATE: Burlington, WA 98233 PROJECT TITLE: Broadway Bridge Replacement WORK ORDER NO. PW3395 DATE WORK COMPLETE: April 15, 2016 FINAL AMOUNT: $7,800,022.66 Exclusive of State Sales Tax CONTRACTOR'S CERTIFICATION I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials from any employee of the City; I further certify that the attached final estimate is a true and correct statement showing all the monies due me from the City of Everett under this contract; that I have carefully examined said final estimate and understand the same and that I hereby release the City of Everett from any and all claims of whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in said estimate. ��/ X President CONTRACTOR TITLE Interwest Construction Subscribed and sworn to before me this 15th day of September , 2016 x Jita_ Cht,?i Not lic u L� � �l�lli�i ; � •• • io•• of Washington,residing at Bellingham *OTAgy - n '0lmBL • o, p�� PUBLIC WORKS DEPARTMENT CERTIFICATION � • W I Certify lip j mal estimate to be based upon actua measurements and to be true and correct. APPROVED Date L 1, x Ox i A _OF Construction Manager Public ? 7 Di ector Tom Fuchs Dave Davis INSTRUCTIONS The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's agents and forwarded with the Final Contract Voucher Certification. Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim attached. Revised 6/2012