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• <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CER111-4CATION <br /> DATE: September 8,2016 ADDRESS: 609 North Hill BLVD <br /> CONTRACTOR: Interwest Construction CITY/STATE: Burlington, WA 98233 <br /> PROJECT TITLE: Broadway Bridge Replacement WORK ORDER NO. PW3395 <br /> DA 1:E WORK COMPLE 1'E: April 15,2016 FINAL AMOUNT: $7,800,022.66 <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 estimate. <br /> X X <br /> President <br /> CONTRACTOR TITLE <br /> Interwest Construction <br /> Subscribed and sworn to before me this 15th day of September ,2016 <br /> X CZ~-- mid ,Olh !'Gt- -c <br /> No ublic' I <br /> j fit 6t4tate of Washington,residing at Bellingham <br /> .7Z * TAS&�. <br /> aen: moo - sp= <br /> NAS <br /> ' <br /> ® J8L� o®�` PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> s�®17):`;I/NE/6 2p2 � e% <br /> I Cer * + final estimate to be <br /> based upon% . measurements and to <br /> be true and correct. APPROVED I.te: j , U kcjCAra-- <br /> x <br /> X i/ <br /> Construction Manager Public Wo T i irectoor <br /> Tom Fuchs Dave Davis <br /> INSTRUCTIONS <br /> • <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor' <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 /> 58 <br />